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Gupta S, Gupta SK, Mittal A, Passi D, Goyal J. Effect of preoperative ibuprofen on pain after lower third molar removal: A randomized controlled trial. Natl J Maxillofac Surg 2023; 14:294-299. [PMID: 37661996 PMCID: PMC10474544 DOI: 10.4103/njms.njms_316_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/18/2021] [Accepted: 09/12/2021] [Indexed: 09/05/2023] Open
Abstract
Aim The aim of the study is to predict the effect of preemptive analgesics in the third molar surgery and to analyze whether the number and frequency of postoperative analgesics are reduced following the administration of preemptive analgesics. Materials and Methods The present study was carried out on 50 patients who reported to the Department of Oral and Maxillofacial Surgery for removal of their impacted mandibular third molar. The patients were randomly divided into two groups of 25 patients each - Group A (test group) patients receiving ibuprofen (400 mg) half an hour before the surgery and placebo half an hour after surgery and the Group B (control group) patients receiving placebo half an hour before the surgery and ibuprofen (400 mg) half an hour after surgery. Both groups of patients will be instructed to avoid any drug but those prescribed (ibuprofen 400 mg SOS and rescue medication of tramadol 50 mg SOS) and not to seek any medical help elsewhere for postoperative problems. The pain was recorded using a visual analog scale. Results Demographic data in the study show females (8%) and male (92%) patients. The average time taken for surgery was more in the control group (58.36 min) as compared to the test group (55.64 min) with no statistically significant difference. Values of pain score, medication score, number of rescue medication, and frequency at different time intervals (at baseline, after 3 h, 6 h, 24 h, and 7 days) are expressed in terms of mean and standard deviation, respectively, and the result shows the statistically significant difference for pain score at baseline and 7th-day time interval only. The distribution of different types of impaction and different types of elevation/odontotomy shows a significant association in test and control groups. Conclusion Preoperative ibuprofen decreases the frequency and intensity of the pain. We believe that since this preoperative ibuprofen seems to be beneficial without any adverse effects, it may be used routinely in the 3rd molar surgeries and even in routine extraction.
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Affiliation(s)
- Sameer Gupta
- Department of Oral and Maxillofacial Surgery, DJ College of Dental Sciences and Research, Ghaziabad, India
| | | | - Ankur Mittal
- Department of Oral and Maxillofacial Surgery, DJ College of Dental Sciences and Research, Ghaziabad, India
| | - Deepak Passi
- Department of Dentistry, CHC Mirzapur, Azamgarh, Uttar Pradesh, India
| | - Jyoti Goyal
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Delhi, India
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Altaweel AA, El-Hamid Gaber A, Alnaffar MZ, Almowallad AS, Almech MH, Almuwallad AS, Alharbi RK, Arab WA. A novel therapeutic approach for reducing postoperative inflammatory complications after impacted mandibular third molar removal. Medicine (Baltimore) 2022; 101:e30436. [PMID: 36123843 PMCID: PMC9478325 DOI: 10.1097/md.0000000000030436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study was designed to compare effect of combined use of dexamethasone and honey versus each agent alone in controlling complications associated with removal of impacted mandibular third molar. METHODS This randomized clinical study included patients suffering from impacted mandibular wisdom teeth. Patients were divided randomly into 4 groups. Group I, control, group II, received dexamethasone injection preoperatively, group III, received honey locally in the wound after extraction, and group IV, received dexamethasone injection preoperatively and topical honey application. All patients were evaluated preoperatively and postoperatively to assess facial edema, interincisal distance, pain, and total analgesic dose used. RESULTS Significant edema developed in group I than other groups and improved significantly in group II and III on seventh postoperative day, and tenth postoperative day in group I. Insignificant edema developed in group IV. Significant decrease in interincisal distance occurred in all groups on third postoperative day that improved significantly on seventh postoperative days in all groups except group I, it improved on tenth postoperative day. Pain was significantly minimum in group IV than other groups and its maximum degree was in group I. CONCLUSION Both dexamethasone and honey are an effective way of minimizing swelling, pain, and trismus after removal of impacted lower third molars. Both agents either alone or in combination provide simple, safe, painless, and cost-effective method to eliminate postoperative discomfort. However, dexamethasone or honey can decrease complications related to surgical extraction of mandibular third molar, the simultaneous application of both agents is more effective method in this regard.
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Affiliation(s)
- Alaa Abdelqader Altaweel
- Oral & Maxillofacial Surgery, Faculty of Dental Medicine for Boys, Al-Azhar University, Cairo, Egypt
- Consultant of Oral & Maxillofacial Surgery, Nahdicare Clinics, Jeddah, Saudi Arabia
- *Correspondence: Alaa Abdelqader Altaweel, Faculty of Dental Medicine for Boys, Al-Azhar University, AL Mokhaym AL Daem St., Nasr City, Cairo 11751, Egypt (e-mail: )
| | - Abd El-Hamid Gaber
- Clinical Pharmacology, Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Mahmoud Z. Alnaffar
- Periodontology and Preventive Dentistry, Vision Colleges, Jeddah, Saudi Arabia
| | | | | | | | | | - Wasan A. Arab
- Dental Intern at Vision Colleges, Jeddah, Saudi Arabia
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Ramos EU, Benetti LP, Oliveira JCS, Bassi APF. Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial. Eur J Dent 2021; 16:396-402. [PMID: 34937107 PMCID: PMC9339938 DOI: 10.1055/s-0041-1735910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective
We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone.
Materials and Methods
The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total
n
= 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura.
Statistical Analysis
For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05.
Results
The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (
p
< 0.05), while for postoperative trismus, there was no statistically significant difference (
p
> 0.05) between the scores of Group A and Group B.
Conclusion
As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.
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Affiliation(s)
- Edith Umasi Ramos
- Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Luan Pier Benetti
- Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Júlio César Silva Oliveira
- Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Ana Paula Farnezi Bassi
- Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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Martins-de-Barros AV, Barros AM, Siqueira AK, Lucena EE, Sette de Souza PH, Araújo FA. Is Dexamethasone superior to Ketorolac in reducing pain, swelling and trismus following mandibular third molar removal? A split mouth triple-blind randomized clinical trial. Med Oral Patol Oral Cir Bucal 2021; 26:e141-e150. [PMID: 33247572 PMCID: PMC7980286 DOI: 10.4317/medoral.24088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/08/2020] [Indexed: 11/17/2022] Open
Abstract
Background The preemptive use of anti-inflammatory drugs, such as corticosteroids and NSAIDs, has the potential to reduce pain, swelling and trismus following oral surgery. The aim of this study was to compare the efficacy of dexamethasone and ketorolac tromethamine in reducing pain, swelling and trismus after mandibular third molar removal.
Material and Methods The researches implemented a triple-blind, randomized clinical trial. The study was conducted with ASA I individuals aging between 18 and 35 years, which were randomized and submitted to two interventions, one with 8mg dexamethasone and the other with 20mg ketorolac tromethamine given 1h before the procedure. The primary predictor variable was the use of dexamethasone or ketorolac. The primary outcome variable was the postoperative pain level, measured with a Visual Analogue Scale. The secondary outcome variables were the amount of rescue analgesic consumed, swelling and trismus. Repeated-measures ANOVA and t-test for paired samples were used to compare the means. Significance was set at p < 0.05.
Results Fifty individuals were randomized and allocated to intervention, and the sample was composed of 40 subjects who completed the study (27 female and 13 male). Dexamethasone, when compared to ketorolac tromethamine, showed a significantly higher reduction in pain level at 8h, 16h, 24h, 32h, 40h and 72h, in swelling and trismus at 24h, 48h, 72h and 7 days and in total number of rescue analgesics taken up to 72h postoperative (p < 0.05).
Conclusions The clinical performance of dexamethasone in controlling pain, swelling and trismus after mandibular third molar removal was superior to ketorolac tromethamine’s. Key words:Third Molar, anti-inflammatory agents, dexamethasone, ketorolac.
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Affiliation(s)
- A-V Martins-de-Barros
- Hospital Universitário Oswaldo Cruz University of Pernambuco, Campus Santo Amaro Rua Arnóbio Marquês, 310 Santo Amaro, Recife, Pernambuco, Brazil
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Kano K, Kawamura K, Miyake T. Effects of preemptive analgesia with intravenous acetaminophen on postoperative pain relief in patients undergoing third molar surgery: a prospective, single-blind, randomized controlled trial. Med Oral Patol Oral Cir Bucal 2021; 26:e64-e70. [PMID: 33037803 PMCID: PMC7806347 DOI: 10.4317/medoral.23983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/17/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The efficacy of preemptive analgesia in managing postoperative pain remains controversial. The aim of this study was to compare the efficacy of intravenous (IV) acetaminophen administered before or immediately after the surgical extraction of an impacted mandibular third molar. MATERIAL AND METHODS This prospective randomized clinical trial included 120 patients. The patients were assigned to one of three groups: the preoperative-treatment group (pre-group), which received 1000 mg of IV acetaminophen 20 min before surgery; the postoperative-treatment group (post-group), which received 1000 mg of IV acetaminophen after surgery; the no-treatment group (control-group), which did not receive any analgesic. Rescue analgesic (60 mg loxoprofen) was issued to each patient, with instructions on self-administration if needed. For the rescue medication usage, the time of first loxoprofen usage and the total amount of loxoprofen consumption were obtained for a 17-hour period after surgery. We measured pain using the visual analogue scale at 1 hour and at 2, 3, 4, 5, and 15 hours after surgery. RESULTS There was no significant difference in pain level among the three groups at any time interval. However, the pre-group demonstrated significantly lower rescue analgesic consumption and longer time until initial administration. CONCLUSIONS Administration of IV acetaminophen before third molar surgery provides more effective pain control than postoperative administration and no treatment.
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Affiliation(s)
- K Kano
- Graduate School of Dentistry, Osaka Dental University Kuzuhahanazono-cho 8-1, Hirakata-shi Osaka 573-1211, Japan
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Pathi J, Vidya KC, Sangamesh NC. Tramadol versus ketorolac for pain management after third molar surgery. Natl J Maxillofac Surg 2020; 11:236-240. [PMID: 33897187 PMCID: PMC8051645 DOI: 10.4103/njms.njms_78_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/18/2019] [Accepted: 08/01/2019] [Indexed: 01/08/2023] Open
Abstract
Objectives: To compare the analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery. Methodology: Two hundred patients in the age group of 18–40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups (100 in each group) and underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary end points: pain intensity being measured hourly by Wong-Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient's global assessment. Results: Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug-related complications were mild and did not require any investigation. Conclusion: The result of the present study shows that preoperative IV ketorolac 30 mg is more effective than tramadol 50 mg for postoperative pain following third molar surgery.
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Affiliation(s)
- Jugajyoti Pathi
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - K C Vidya
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - N C Sangamesh
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
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7
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Optimal analgesic dose of ketorolac for use in the perioperative period. J Clin Anesth 2020; 68:110081. [PMID: 33011670 DOI: 10.1016/j.jclinane.2020.110081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
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8
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Ramires GAD, de Souza Santos AM, Momesso GAC, Polo TOB, Silva WPP, Barbosa S, Bassi APF, Faverani LP. Combination of etodolac and dexamethasone improves preemptive analgesia in third molar surgery: a randomized study. Clin Oral Investig 2020; 25:2297-2305. [PMID: 32875383 DOI: 10.1007/s00784-020-03552-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This randomized, controlled, triple-blind, crossover clinical trial aimed to investigate the use of dexamethasone (DEX) and etodolac (ETO) as preemptive analgesia before mandibular third molar extraction. METHODS Patients were divided into three groups (n = 20 teeth each) based on the drug administered: DEX 8 mg (DEX); DEX 8 mg plus ETO 300 mg (DEX + ETO), and ETO 300 mg (ETO). Paracetamol (750 mg) tablets were administered as rescue analgesics. Pain was evaluated using the visual analog scale (VAS) at 6, 12, 24, 48, and 72 h and 7 days postoperatively. Edema and trismus were assessed 48 and 72 h postoperatively. All data were subjected to statistical analysis, where a P value < .05 indicated statistical significance. RESULTS VAS scores and the number of rescue analgesics taken were lower in the DEX + ETO group than in the other groups (P < .001 and P = .014, respectively). At 48 h, trismus was similar among all groups; however, the ETO group showed the highest trismus 7 days postoperatively (P < .05). Edema was similar among all groups at all time points (P > .05). CONCLUSION The combined use of the anti-inflammatory drugs, DEX and ETO, resulted in better pain control and the need for fewer rescue analgesics than the use of either drug alone, which indicated their effectiveness in mandibular third molar extractions preoperatively. CLINICAL RELEVANCE This drug combination can lead to less pain, edema, and trismus and reduce the use of rescue analgesics in the postoperative period.
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Affiliation(s)
- Guilherme André D Ramires
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Anderson Maikon de Souza Santos
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Gustavo A C Momesso
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Tárik Ocon B Polo
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - William P P Silva
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Stéfany Barbosa
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Ana Paula F Bassi
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil.
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The Effect of Computer-Assisted Visual Information on Dental Fear Before Periodontal Surgery. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.648947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Martins LD, Rezende M, Loguercio AD, Bortoluzzi MC, Reis A. Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial. Med Oral Patol Oral Cir Bucal 2019; 24:e96-e102. [PMID: 30573715 PMCID: PMC6344016 DOI: 10.4317/medoral.22744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 11/02/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND This study compared the efficacy of ketorolac alone versus its combination with tramadol/acetaminophen for pain control after mandibular third molar surgery. MATERIAL AND METHODS A randomized, triple-blind clinical trial was carried out with 52 patients divided into 2 groups: Group K+T+A (1 tablet of Ketorolac 10 mg plus and 1 capsule of Tramadol 37.5 mg/acetaminophen 325 mg) and Group K (1 tablet of Ketorolac 10 mg plus and 1 placebo capsule). The treatments were given 1 h before the surgery and was repeated 4 times per day, for 48 h. The difference in postoperative pain was assessed by 4 primary end-points: pain intensity (VAS 100mm, for 48 h), rescue medication, overall assessment and adverse effects. RESULTS Significant differences in pain intensity were observed in the different times (p < 0.05). The comparison of groups in each time showed significant differences only of 9 h, with lower level of pain intensity for group K+T+A (p = 0.005). The need of analgesics was higher in Group K (p < 0.001), the need of antiemetic were greater in Group K+T+A (p < 0.0001). No significant difference between groups were observed in overall assessment. The adverse effects was higher in Group K+T+A. CONCLUSIONS The current study showed that both ketorolac and the combination of ketorolac plus tramadol/acetaminophen showed good control of pain after the extraction of the lower third molars. Although the combination group showed lower pain at 9 h, the difference is small and not clinically relevant.
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Affiliation(s)
- L-D Martins
- Rua Carlos Cavalcanti, 4748 Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, Brazil 84030-900,
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Favarini VT, Lima CAA, da Silva RA, Sato FRL. Is dipyrone effective as a preemptive analgesic in third molar surgery? A pilot study. Oral Maxillofac Surg 2018; 22:71-75. [PMID: 29353426 DOI: 10.1007/s10006-018-0669-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 12/28/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Studies on preemptive analgesia in maxillofacial surgery have shown several controversial clinical results, mainly due to the absence of a methodological standard, besides a wide variety of studied drugs. This study intended to answer the following hypothesis: Is the administration of dipyrone preemptively capable of decreasing trans- and postoperative pain in the third molar surgical extraction? METHODS A pilot prospective double-blind placebo-controlled study was carried out with 25 patients submitted to the third molar surgical extraction at two moments, one side in each intervention. Dipyrone (1 g) was preemptively administered (study group) for the extraction of two third molars on the same side and, in a second surgical procedure, dipyrone (1 g) was administered in the immediate postoperative period (control group). Evaluated variables were the amount of anesthetic, pain perceived through the visual analogue scale (VAS) in transoperative and immediate postoperative periods, and over 12-h investigation period, analgesic consumption, duration of surgery, and time to rescue analgesia. RESULTS The results were submitted to Student's t test and statistical differences were observed in transoperative (p < 0.05) and immediate postoperative (p < 0.01) periods, while the other studied variables did not present statistical differences. CONCLUSION The preemptive administration of dipyrone decreased the perception of transoperative and immediate postoperative pain when compared to its use after surgery only.
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Affiliation(s)
| | | | - Rogério Almeida da Silva
- Chief of Oral and Maxillofacial Surgery Department, Hospital Geral de Vila Penteado, São Paulo, Brazil
| | - Fábio Ricardo Loureiro Sato
- Department of Oral and Maxillofacial Surgery State University of São Paulo UNESP, College of Dentistry São José dos Campos and Oral and Maxillofacial Surgeon, Hospital Geral de Vila Penteado, Av. Eng. Francisco José Longo, 777, São José dos Campos, SP, 12245-000, Brazil.
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Nezafati S, Khiavi RK, Mirinejhad SS, Ammadi DA, Ghanizadeh M. Comparison of Pain Relief from Different Intravenous Doses of Ketorolac after Reduction of Mandibular Fractures. J Clin Diagn Res 2017; 11:PC06-PC10. [PMID: 29207772 DOI: 10.7860/jcdr/2017/30946.10558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/24/2017] [Indexed: 11/24/2022]
Abstract
Introduction Pain is an unpleasant feeling due to tissue destruction, which disturbs an individual's daily routines even at its lowest levels. The majority of surgeons and anaesthesiologists are increasingly trying to administer non-opioid analgesics because excessive use of opioids after surgery results in patient dissatisfaction. Aim To evaluate the analgesic effect of intravenous injection of different doses of ketorolac at different intervals in patients undergoing surgery for unilateral fractures of the mandible. Materials and Methods In the present randomized clinical trial (March 2016 to January 2017, in Tabriz Imam Reza Treatment/Educational Center), 50 patients were assigned to five groups with simple randomization method. In Group 1 and 2, immediately before the induction of general anaesthesia 30 and 60 mg of ketorolac and in Group 3 and 4, immediately before termination of surgery 30 and 60 mg of ketorolac was injected intravenously. In Group 5, ketorolac was not administered. After each patient regained complete consciousness, the severity of pain was determined using VAS up to 24 hours at baseline and at 2, 4, 6, 12 and 24-hours intervals. The total dose of the opioid analgesic agent (morphine-pethidine) and the time for the first request for an analgesic agent were recorded for each patient and their means were compared in each group with suitable statistical tests. Results The patients in Group 5 and 4 exhibited the highest and lowest mean pain scores (5.03±0.9 and 3.5±1), respectively. ANOVA for repeated measures and post-hoc Tukey tests showed significant differences only between Group 3 and 5 (p=0.002) and Group 4 and 5 (p=0.001), with no significant differences between the other groups (p>0.005). The highest dose of the analgesic agent was in Group 5 (5.3±1.4 mg) and the lowest dose was recorded in Group 4 (1.6±0.6 mg). Patients in the control group received significantly higher doses compared to the other groups (p<0.05). The patients in Group 1 and 2 received higher doses of analgesics compared to Group 3 and 4 (p<0.05). The longest time for the request for the first dose of analgesic agent after surgery was 73.4±12.03 minutes in Group 4 The patients in the control group had requested analgesics after surgery at a significantly shorter time compared to the patients in all the study groups (p<0.05). The patients in Group 1 and 2 had requested analgesics at a shorter time after surgery compared to the subjects in Group 3 and 4 (p<0.05). Conclusion Intravenous administration of 30 and 60 mg of ketorolac, immediately before termination of surgery, decreases the pain severity and the need for opioid analgesics after surgery.
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Affiliation(s)
- Saeed Nezafati
- Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Azadi Street, Iran
| | - Reza Khorshidi Khiavi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Azadi Street, Iran
| | - Seyyed Sina Mirinejhad
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Azadi Street, Iran
| | - Dawood Aghamoh Ammadi
- Associate Professor, Department of Anaesthesiology, Tabriz University of Medical Sciences, Tabriz, Azadi Street, Iran
| | - Milad Ghanizadeh
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, Tabriz University of Medical Sciences, Tabriz, Azadi Street, Iran
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14
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Barbalho J, Vasconcellos R, de Morais H, Santos L, Almeida RDA, Rêbelo H, Lucena E, de Araújo S. Effects of co-administered dexamethasone and nimesulide on pain, swelling, and trismus following third molar surgery: a randomized, triple-blind, controlled clinical trial. Int J Oral Maxillofac Surg 2017; 46:236-242. [DOI: 10.1016/j.ijom.2016.10.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/04/2016] [Accepted: 10/14/2016] [Indexed: 11/25/2022]
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Mojsa IM, Stypulkowska J, Novak P, Lipczynski K, Szczeklik K, Zaleska M. Pre-emptive analgesic effect of lornoxicam in mandibular third molar surgery: a prospective, randomized, double-blind clinical trial. Int J Oral Maxillofac Surg 2017; 46:614-620. [PMID: 28057390 DOI: 10.1016/j.ijom.2016.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/14/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
The aim of this study was to establish whether the pre-emptive use of lornoxicam (16mg) in third molar surgery ensures successful postoperative analgesia and reduces rescue analgesic intake when compared to postoperative application, and in comparison with placebo. Ninety patients were split randomly into three groups: group A received lornoxicam 60min before surgery and placebo 60min after surgery; group B received placebo 60min before surgery and lornoxicam 60min after surgery; group C received placebo 60min before surgery and placebo 60min after surgery. Postoperative pain was recorded on a visual analogue scale and on a numerical rating scale at 1, 2, 4, 6, 8, 12, and 24h after surgery. The patients recorded total dose of paracetamol intake during the 24h after the procedure. The efficacy of postoperative analgesia was greater in lornoxicam groups when compared to the placebo group; there was no difference between the two lornoxicam groups (A and B). Patients in group C took their first rescue analgesic dose earlier after surgery than patients in the two lornoxicam groups. The average dose of paracetamol taken in group C was 1000mg, while it was500 mg in the lornoxicam groups.
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Affiliation(s)
- I M Mojsa
- Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland.
| | - J Stypulkowska
- Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - P Novak
- Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - K Lipczynski
- Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - K Szczeklik
- Department of Integrated Dentistry, Jagiellonian University Medical College, Krakow, Poland
| | - M Zaleska
- Department of Oral Surgery, Jagiellonian University Medical College, Krakow, Poland
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16
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Kaplan V, Eroğlu CN. Comparison of the Effects of Daily Single-Dose Use of Flurbiprofen, Diclofenac Sodium, and Tenoxicam on Postoperative Pain, Swelling, and Trismus: A Randomized Double-Blind Study. J Oral Maxillofac Surg 2016; 74:1946.e1-6. [DOI: 10.1016/j.joms.2016.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/13/2016] [Accepted: 05/13/2016] [Indexed: 11/25/2022]
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Isiordia-Espinoza MA, Pozos-Guillen A, Martinez-Rider R, Perez-Urizar J. Comparison of the analgesic efficacy of oral ketorolac versus intramuscular tramadol after third molar surgery: A parallel, double-blind, randomized, placebo-controlled clinical trial. Med Oral Patol Oral Cir Bucal 2016; 21:e637-43. [PMID: 27475688 PMCID: PMC5005104 DOI: 10.4317/medoral.21077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 04/30/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Preemptive analgesia is considered an alternative for treating the postsurgical pain of third molar removal. The aim of this study was to evaluate the preemptive analgesic efficacy of oral ketorolac versus intramuscular tramadol after a mandibular third molar surgery. MATERIAL AND METHODS A parallel, double-blind, randomized, placebo-controlled clinical trial was carried out. Thirty patients were randomized into two treatment groups using a series of random numbers: Group A, oral ketorolac 10 mg plus intramuscular placebo (1 mL saline solution); or Group B, oral placebo (similar tablet to oral ketorolac) plus intramuscular tramadol 50 mg diluted in 1 mL saline solution. These treatments were given 30 min before the surgery. We evaluated the time of first analgesic rescue medication, pain intensity, total analgesic consumption and adverse effects. RESULTS Patients taking oral ketorolac had longer time of analgesic covering and less postoperative pain when compared with patients receiving intramuscular tramadol. CONCLUSIONS According to the VAS and UAC results, this study suggests that 10 mg of oral ketorolac had superior analgesic effect than 50 mg of tramadol when administered before a mandibular third molar surgery.
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Affiliation(s)
- M-A Isiordia-Espinoza
- Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava #2, Zona Universitaria, C.P. 78290, San Luis Potosí, S.L.P. México,
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Alan H, Yolcu Ü, Koparal M, Özgür C, Öztürk SA, Malkoç S. Evaluation of the effects of the low-level laser therapy on swelling, pain, and trismus after removal of impacted lower third molar. Head Face Med 2016; 12:25. [PMID: 27457369 PMCID: PMC4960798 DOI: 10.1186/s13005-016-0121-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/20/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In current study we aimed to examine the effect of a low-level laser therapy on the pain, mouth opening and swelling of patients whose impacted 3rd molar tooth was extracted in addition measurement volumetrically to the edema with 3dMD face system. METHODS It was surveyed 15 patients who had bilateral symmetric lower 3rd molars. Surgical sides of patients were randomly separated into two groups: the study group and the control group. It was applied extra oral low-level laser therapy (LLLT, 0.3 W, 40 s, 4 J/cm(2)) to the study group (n = 15) after the surgical operation and on the 2nd day. Only routine postoperative recommendation (ice application) was made in the control (n = 15) group. The maximum mouth opening, pain level and facial swelling evaluated. 3dMD Face® (3dMD, Atlanta, GA) Photogrammetric System was used to evaluate volumetric changes of the swelling. RESULTS There was no statistically significant difference in the edema and interincisal opening between the groups and the pain level in the laser group was significantly lower than in the control group on the 7(th) postoperative day. CONCLUSIONS Although there were decreasing trismus, swelling, and pain level, with this LLLT, there was significant difference only in the 7th day pain level in the laser group compared with the control group.
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Affiliation(s)
- Hilal Alan
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey.
| | - Ümit Yolcu
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey
| | - Mahmut Koparal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Cem Özgür
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey
| | - Seyit Ahmet Öztürk
- Department of Ortodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Sıddık Malkoç
- Department of Ortodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Sindjelic R, Davidovic L, Vlajkovic G, Markovic M, Kuzmanović I. Pain Associated with Carotid Artery Surgery Performed under Carotid Plexus Block: Preemptive Analgesic Effect of Ketorolac. Vascular 2016; 14:75-80. [PMID: 16956475 DOI: 10.2310/6670.2006.00013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Carotid artery surgery (CAS) performed under cervical plexus block is frequently associated with significant intra- and postoperative pain. To evaluate whether preoperative administration of ketorolac may improve analgesia in this type of surgery, 80 patients scheduled for CAS under cervical plexus block were randomly allocated to receive intravenously either 30 mg of ketorolac or placebo 30 minutes before surgery. Verbal rating scale pain scores during surgery and 3 and 6 hours after surgery, the number of patients requiring additional analgesia, and the total analgesic consumption both during and within 6 hours after surgery were significantly lower, whereas the time to first postoperative analgesia was significantly shorter in the ketorolac group than in the control group. The results of this prospective, randomized, double-blind study show that a single 30 mg dose of ketorolac administered intravenously 30 minutes before surgery reduces intraoperative pain and preempts postoperative pain in patients undergoing CAS under carotid plexus block.
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Affiliation(s)
- Radomir Sindjelic
- Department of Ophthalmic Anesthesia, Institute for Anesthesia and Reanimation, Clinical Centre of Serbia, Belgrade, Serbia and Montenegro
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Paiva-Oliveira JG, Bastos PRHO, Cury Pontes ERJ, da Silva JCL, Delgado JAB, Oshiro-Filho NT. Comparison of the anti-inflammatory effect of dexamethasone and ketorolac in the extractions of third molars. Oral Maxillofac Surg 2016; 20:123-133. [PMID: 26572899 DOI: 10.1007/s10006-015-0533-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 11/01/2015] [Indexed: 06/05/2023]
Abstract
This double-blind, split-mouth, and randomized study was aimed to compare the efficacy of dexamethasone and ketorolac tromethamine, through the evaluation of pain, edema, and limitation of mouth opening. Thirty-four individuals aged 18-26 years, having bilateral mandibular third molars, in a similar position, were selected. Two different surgical procedures were performed on the same individual by the single surgeon. For an extraction, the individual received 1 capsule of 10 mg ketorolac tromethamine 1 h before surgery and every 8 h for 2 days. For the extraction of the contralateral side, the individual received 1 capsule of 8 mg dexamethasone 1 h before surgery and 1 placebo capsule every 8 h for 2 days. Sodium metamizol, 500 mg, was given as rescue medication in postoperative. Pain was assessed by the Visual Box Scale-11 points (BS-11) at 24 h postoperative. Edema (metric measurement) and the maximum mouth opening (interincisal) were recorded in the pre-operative, 24 h, 48 h, 72 h and 7 days postoperatively. The results showed that both therapeutic treatments used were effective in the postoperative, and there were no statistically significant differences between the groups for the pain and edema variables. However, for the limitation of mouth opening, 24 h and 7 days postoperatively, the dexamethasone group had a lower limitation of mouth opening, behaving better than the ketorolac for this variable in these periods. Due also to the higher margin of safety, the use of dexamethasone as a single dose becomes a more suitable alternative for use in routine surgical extractions of third molars.
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Affiliation(s)
- Janayna Gomes Paiva-Oliveira
- Program in Health Science and Development of the Midwest Region of the Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
| | - Paulo Roberto Haidamus Oliveira Bastos
- Program in Health Science and Development of the Midwest Region of the Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Elenir R J Cury Pontes
- Program in Health Science and Development of the Midwest Region of the Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Júlio César Leite da Silva
- Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
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Mony D, Kulkarni D, Shetty L. Comparative Evaluation of Preemptive Analgesic Effect of Injected Intramuscular Diclofenac and Ketorolac after Third Molar Surgery- A Randomized Controlled Trial. J Clin Diagn Res 2016; 10:ZC102-6. [PMID: 27504398 DOI: 10.7860/jcdr/2016/17696.8045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 04/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Analgesia pre-emptively administered effect-ively aid in management of pain. Pre-emptive analgesia is anti-nociceptive treatment which prevents altered central sensitization of afferent inputs. AIM To compare and evaluate the pre-emptive analgesic efficacy of preoperatively administered ketorolac and diclofenac for controlling postoperative pain after third molar surgery. MATERIALS AND METHODS A total of 50 patients with symmetrically impacted third molars were divided into two groups, 30mg intramuscular injection of ketorolac and 75 mg diclofenac sodium were used in the respective groups. The visual analogue scale was used to assess post operative pain for three days and the patients were also evaluated for the number of rescue analgesia. RESULTS The data was statistically evaluated with paired t- test. The maximum time taken for pain perception for Group A Ketoralac was 5.48 hrs and Group B Diclofenac sodium was 4.9 hrs and p=0.235 which was not significant. The mean number of tablets taken by the patients in the first three post operative days was 3.24 in Group A i.e., Ketorolac and 4.04 in Group B i.e., Diclofenac sodium. The values were compared using the paired t test. The p value = 0.004, which was significant. CONCLUSION Ketoralac showed better pre-emptive analgesic effect for post-operative pain management after third molar extraction. The immediate post-operative pain free period provided by both ketorolac and diclofenac by intramuscular route was same.
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Affiliation(s)
- Deepthi Mony
- Lecturer, Department of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth , Pune, Maharashtra, India
| | - Deepak Kulkarni
- Professor and Head, Department of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth , Pune, Maharashtra, India
| | - Lakshmi Shetty
- Associate Professor, Department of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth , Pune, Maharashtra, India
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Saad SS, Hamza M, Bahr MH, Masoud SI. Nitric oxide is involved in ibuprofen preemptive analgesic effect in the plantar incisional model of postsurgical pain in mice. Neurosci Lett 2016; 614:33-8. [DOI: 10.1016/j.neulet.2015.12.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/03/2015] [Accepted: 12/15/2015] [Indexed: 11/29/2022]
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Liporaci Junior JLJ. Assessment of preemptive analgesia efficacy in surgical extraction of third molars. Rev Bras Anestesiol 2015; 62:502-10. [PMID: 22793965 DOI: 10.1016/s0034-7094(12)70148-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Accepted: 09/12/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Literature on preemptive analgesia is controversial. Reliability of results and difficult reproducibility of research contribute for non-elucidation of the subject. The aim of this study is to test the efficacy of oral ketoprofen (150 mg) preemptively administrated two days before third molar surgery, compared with postoperative administration in the same patient. METHODS Thirteen patients underwent surgical removal of bilateral third molar in two separate procedures. In a random and double blind procedure, oral ketoprofen 150 mg was administered every 12 hours two days before surgery and, after the procedure, the same drug was administered for three days. On the other side, a control (placebo) was used orally every 12 hours two days before surgery and, after the procedure, ketoprofen 150 mg was administered every 12 hours for three days. Postoperative pain was assessed by visual analogue scale, nominal scale, and amount of rescue analgesics consumed. RESULTS There was no statistically significant difference in postoperative pain between the preemptive treatment and control. CONCLUSION In this experimental model, preemptive analgesia was not effective in reducing postoperative pain in surgical extraction of third molar compared with the postoperative administration of the same drug.
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Costa FWG, Soares ECS, Esses DFS, Silva PGD, Bezerra TP, Scarparo HC, Ribeiro TR, Fonteles CSR. A split-mouth, randomized, triple-blind, placebo-controlled study to analyze the pre-emptive effect of etoricoxib 120 mg on inflammatory events following removal of unerupted mandibular third molars. Int J Oral Maxillofac Surg 2015; 44:1166-74. [PMID: 26144571 DOI: 10.1016/j.ijom.2015.06.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 11/26/2022]
Abstract
Pain after third molar extraction has been considered the most suitable pharmaceutical model to evaluate acute pain. This study aimed to evaluate the pre-emptive analgesic/anti-inflammatory efficacy of etoricoxib 120 mg following mandibular third molar surgery. A split-mouth, randomized, triple-blind, placebo-controlled study was conducted with patients undergoing the surgical removal of mandibular third molars. All volunteers were allocated randomly to receive either etoricoxib 120 mg or placebo 1h preoperatively, and inflammatory events were evaluated. An estimated sample of 18 surgical units per group was required based on a pilot study (95% confidence level and 80% statistical power). Rescue medication was analyzed by Kaplan-Meier method through log-rank Mantel-Cox test and Pearson linear correlation (P<0.05). Pre-emptive etoricoxib reduced postoperative pain scores significantly in comparison to placebo (P<0.001), with a pain score peak at 6h after surgery (P<0.001). The mean rescue medication consumption was lower in the etoricoxib group compared to the placebo group over the study period (P<0.05). There was no statistically significant difference between groups related to swelling and trismus. The pre-emptive administration of etoricoxib 120 mg significantly reduced the postoperative pain intensity and the need for rescue medication, but did not reduce swelling or trismus.
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Affiliation(s)
- F W G Costa
- Division of Oral Surgery, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - E C S Soares
- Division of Oral Surgery, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - D F S Esses
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - P G deB Silva
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - T P Bezerra
- Division of Oral Surgery, Walter Cantidio University Hospital, Fortaleza, Ceará, Brazil
| | - H C Scarparo
- Division of Oral Surgery, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil; Division of Clinical Pharmacology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - T R Ribeiro
- Division of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - C S R Fonteles
- Division of Clinical Pharmacology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil; Division of Paediatrics, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized, double-blind study. Int J Oral Maxillofac Surg 2015; 44:876-84. [DOI: 10.1016/j.ijom.2014.10.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 09/30/2014] [Accepted: 10/22/2014] [Indexed: 11/20/2022]
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A Comparative Study Between Bupivacaine with Adrenaline and Carbonated Bupivacaine with Adrenaline for Surgical Removal of Impacted Mandibular Third Molar. J Maxillofac Oral Surg 2015; 15:99-105. [PMID: 26929560 DOI: 10.1007/s12663-015-0791-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 03/30/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To compare the effectiveness of bupivacaine with adrenaline with that of carbonated bupivacaine with adrenaline on pain, onset of anesthesia and duration of anesthesia following surgical removal of impacted mandibular third molar. STUDY DESIGN All the patients who underwent surgical removal of impacted mandibular third molar and who fulfilled our inclusion and exclusion criteria from 1st June 2013 to 30th June 2014 were included in our study. Patients who were diagnosed as having impacted mandibular third molar were randomly allocated to two groups namely group A (bupivacaine with adrenaline), group B (carbonated bupivacaine with adrenaline). Pain during deposition of local anesthetic, onset of anesthesia and duration of anesthesia were compared between the two groups. The collected data were subjected to statistical analysis by Chi Square test, Mann-Whitney U test. RESULTS AND CONCLUSION The efficacy of carbonated bupivacaine with adrenaline is more compared with bupivacaine with adrenaline in decreasing pain on deposition of local anesthetic solution and in rapid onset of anesthesia. The duration of anesthesia for carbonated bupivacaine with adrenaline and bupivacaine with adrenaline had no significant difference. The use of carbonated bupivacaine with adrenaline will reduce the patient discomfort both intra-operatively and post-operatively.
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Kazancioglu HO, Tek M, Ezirganli S, Demirtas N. Does watching a video on third molar surgery increase patients' anxiety level? Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:272-7. [PMID: 25561389 DOI: 10.1016/j.oooo.2014.10.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/26/2014] [Accepted: 10/17/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To identify the effects of watching live taping of third molar removal on patients' anxiety levels before and after extraction. STUDY DESIGN This study was based on a prospective, cross-sectional, observational investigation of the different patient education techniques about the effect of third molar removal on patients' anxiety level. A total of 333 patients were randomized into three groups: two study groups (for group 1, basic information was given verbally; for group 2, which was the study group, basic information was given verbally and through a movie on third molar extraction); and a control group (basic information was given verbally; it did not include information on operative procedures and recovery). Anxiety levels were assessed by using the Dental Anxiety Scale (DAS) and the Spielberger State-Trait Anxiety Inventory (STAI). Pain was assessed with a visual analog scale. Statistical analysis was performed with SPSS 16.0. RESULTS Group 2 patients were significantly more anxious before the surgical procedure, and the most significant decreases in DAS and STAI scores were observed in that group. The age, surgery time, and education level were not correlated with anxiety or pain levels; however, female patients had high levels of anxiety (P < .05). CONCLUSION Preoperative multimedia information increases the anxiety of patients undergoing third molar surgery.
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Affiliation(s)
- Hakki Oguz Kazancioglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mustafa Tek
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Abant Izzet Baysal University, Bolul, Turkey
| | - Seref Ezirganli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Nihat Demirtas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
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Wasson M, Beirne OR. Buprenorphine therapy: an increasing challenge in oral and maxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:142-6. [PMID: 23849373 DOI: 10.1016/j.oooo.2013.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 03/10/2013] [Accepted: 04/27/2013] [Indexed: 11/30/2022]
Abstract
Suboxone is a 4:1 mixture of buprenorphine and naloxone and Subutex is buprenorphine alone. The high affinity μ-receptor binding of buprenorphine (Suboxone and Subutex) renders other opioids ineffective. Inadequate procedural sedation, inadequate analgesia, and significant drug interactions complicate the treatment of patients taking Suboxone or Subutex. Careful planning and an understanding of buprenorphine pharmacology can minimize potential perioperative complications in patients taking Suboxone or Subutex.
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Affiliation(s)
- Michael Wasson
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA 98195-7134, USA
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Gutta R, Koehn CR, James LE. Does Ketorolac Have a Preemptive Analgesic Effect? A Randomized, Double-Blind, Control Study. J Oral Maxillofac Surg 2013; 71:2029-34. [DOI: 10.1016/j.joms.2013.06.220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 06/23/2013] [Accepted: 06/28/2013] [Indexed: 11/27/2022]
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Herrera-Briones FJ, Prados Sánchez E, Reyes Botella C, Vallecillo Capilla M. Update on the use of corticosteroids in third molar surgery: systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e342-51. [DOI: 10.1016/j.oooo.2012.02.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 01/17/2012] [Accepted: 02/01/2012] [Indexed: 10/28/2022]
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Effectiveness of preemptive analgesia on postoperative pain following third molar surgery: Review of literatures. JAPANESE DENTAL SCIENCE REVIEW 2013. [DOI: 10.1016/j.jdsr.2013.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Aravena P, Benso B, Bertín A, Aravena-Torres R. Efectividad de la profilaxis analgésica con clonixinato de lisina en exodoncias: ensayo clínico aleatorio. JOURNAL OF ORAL RESEARCH 2013. [DOI: 10.17126/joralres.2013.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gopalraju P, Lalitha RM, Prasad K, Ranganath K. Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery--a prospective randomized study. J Craniomaxillofac Surg 2013; 42:629-33. [PMID: 24269645 DOI: 10.1016/j.jcms.2013.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 08/30/2013] [Accepted: 09/13/2013] [Indexed: 11/29/2022] Open
Abstract
The aim of this comparative, prospective, randomized, controlled study was to evaluate two different regimens of analgesics: a preoperative intravenous dose of either Tramadol or Ketorolac given 10 min prior to surgery to assess their impact on clinical recovery after third molar surgery. Forty patients requiring surgical extraction of unilateral impacted mandibular third molars similar in position were enrolled in the study. Patients were randomly divided into two groups based on permuting the numbers. Patients in Group 1 and Group 2 were administered either Tramadol 50 mg or Ketorolac 30 mg, intravenously, 10 min prior to surgery. The difference in postoperative pain was assessed by four primary points: pain intensity as measured by a 10 mm visual analogue scale hourly for 12 h, median time to rescue analgesics, number of analgesics consumed and patient's overall 5-point global assessment scale. Throughout the 12 h investigation period, patients treated with Ketorolac reported significantly lower pain intensity scores, significantly longer time to rescue analgesics (Acetaminophen 500 mg) and less intake of postoperative analgesics. In Group 2, 40% of the patient had good overall assessment as compared to Group 1 where only 25% of patients had good overall assessment. The current study shows that pre-emptive use of Inj. Ketorolac 30 mg intravenously can reduce the severity of the postoperative sequelae of asymptomatic impacted mandibular third molar surgery.
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Affiliation(s)
- Prathibha Gopalraju
- Department of Oral and Maxillofacial Surgery, M.S. Ramaiah Dental College and Hospital, New BEL Road, MSR Nagar, MSRIT Post, Bangalore 560 054, India.
| | - Ramanujapuram Manikarnike Lalitha
- Department of Oral and Maxillofacial Surgery, M.S. Ramaiah Dental College and Hospital, New BEL Road, MSR Nagar, MSRIT Post, Bangalore 560 054, India
| | - Kavitha Prasad
- Department of Oral and Maxillofacial Surgery, M.S. Ramaiah Dental College and Hospital, New BEL Road, MSR Nagar, MSRIT Post, Bangalore 560 054, India
| | - Krishnappa Ranganath
- Department of Oral and Maxillofacial Surgery, M.S. Ramaiah Dental College and Hospital, New BEL Road, MSR Nagar, MSRIT Post, Bangalore 560 054, India
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Abstract
INTRODUCTION We have evaluated efficacy of diclofenac sodium as pre-emptive analgesia agent in a prospective triple blind placebo controlled randomized clinical trial in a patients undergoing third molar impaction surgery. MATERIALS AND METHODS Randomization of groups was done by randomization software and two groups were constituted one group receiving placebo pre operatively and then the drug for next five days while the other group was given diclofenac sodium pre operatively and then for five days. RESULTS Results were achieved with help of measurement of outcome variables like postoperative tenderness, swelling and trismus on a visual analogous scale (VAS) and other personalized scale. Collected data shows that there is a significant reduction in the score of postop tenderness in experimental group (P = 0.00), while there is a minimal difference between score of postoperative swelling and tenderness (P > 0.04). CONCLUSION So, we can conclude that use of diclofenac sodium as a preemptive analgesic agent is beneficial for better pain control in third molar impaction surgery.
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Affiliation(s)
- Rakesh Shah
- Department of Oral and Maxillofacial Surgery, K. M. Shah Dental College and Hospital, Piparia, Vadodara, Gujarat, India
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Comparative evaluation of pre-emptive analgesic efficacy of intramuscular ketorolac versus tramadol following third molar surgery. J Maxillofac Oral Surg 2012; 12:197-202. [PMID: 24431839 DOI: 10.1007/s12663-012-0420-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/26/2012] [Indexed: 10/27/2022] Open
Abstract
Pre-emptive analgesia aims at preventing the central nervous system from reaching a hyper-excitable state known as central sensitization, in which it responds excessively to afferent inputs. The clinical implication would be more effective pain management, thereby reducing post-operative pain and analgesic requirements. This study aimed at investigating the existence of pre-emptive analgesia and to compare the pre-emptive analgesic efficacy of im ketorolac [NSAID] versus tramadol [SYNTHETIC OPIOD] for post-operative pain management following third molar surgery. Fifty patients under the age group of 16-25 years with asymptomatic, symmetrically impacted mandibular third molars were equally divided into 2 groups and underwent third molar surgery under local anesthesia. Ketorolac 30 mg and tramadol 50 mg were used in the study group, while sodium chloride 0.9 % was used in the control group. Study parameters included pain intensity scores for 12 post-operative hours, time to 1st rescue analgesia, total number of analgesics consumed during the 5 post-operative days and patients' self assessment of efficacy of the surgery with regardsto no pain. Statistically, the data are presented as the mean values with their standard deviations and a 95 % confidence interval [p is significant, if p < 0.05] for the mean are applicable. Incidences of adverse events like pain on injection of the study drug, local reactions, nausea and vomiting were noted. Patients in the study group significantly performed better than the control group in terms of all the parameters; while among the study group, ketorolac fared better than tramadol. All the drug related complications were mild and did not require any intervention. Pre-operative ketorolac or tramadol in comparison to placebo resulted in a significantly better post-operative pain management. However as against tramadol, ketorolac is a better choice as a pre-emptive analgesic agent for the post-operative pain management following third molar surgery.
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Retrospective evaluation of inpatient celecoxib use after total hip and knee arthroplasty at a Veterans Affairs Medical Center. J Arthroplasty 2012; 27:1033-40. [PMID: 22386610 DOI: 10.1016/j.arth.2012.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 01/20/2012] [Indexed: 02/01/2023] Open
Abstract
A retrospective cohort study (1.5 years) was performed to investigate the efficacy of celecoxib vs non-celecoxib use in patient who underwent total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study time frame encompassed a pre and post period of a local policy decision opening access to short-term celecoxib use after TKA/THA. Primary end point was the amount of opioid use during their inpatient stay postprocedure. The TKA (n = 81) and THA (n = 60) groups were analyzed independently. Both celecoxib groups used significantly less opioids during their inpatient stay vs noncelecoxib groups, given in oral morphine milligram equivalents (TKA: 203 vs 337 mg, P = .002; THA: 214 vs 336 mg, P = .005). Other secondary outcome measures showed that the celecoxib groups also reported reduction in pain scores, total as needed (PRN) opioid doses, PRN opioid doses per day, average dose of PRN opioids, total PRN opioids, use of intravenous opioids, and rehabilitation facility admissions (in the TKA group only). Linear regression analysis showed a statistically significant inverse relationship between opioid consumption and age. Short-term celecoxib use after TKA/THA may lead to a reduction in overall opioid use and improved pain scores; however, further studies will be required to validate the results of this study.
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Aznar-Arasa L, Harutunian K, Figueiredo R, Valmaseda-Castellón E, Gay-Escoda C. Effect of preoperative ibuprofen on pain and swelling after lower third molar removal: a randomized controlled trial. Int J Oral Maxillofac Surg 2012; 41:1005-9. [PMID: 22521671 DOI: 10.1016/j.ijom.2011.12.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/14/2011] [Accepted: 12/19/2011] [Indexed: 10/28/2022]
Abstract
The aim of this study was to compare the analgesic and anti-inflammatory effects of preoperative and postoperative administration of ibuprofen after the surgical removal of impacted lower third molars. A triple-blind, randomized, placebo-controlled clinical trial of 120 patients requiring the surgical removal of lower third molars was performed. The subjects were randomized into the experimental group (patients were administered 600 mg of ibuprofen (p.o.) 1h before the surgical procedure, followed by placebo just after the end of the operation) or into the control group (subjects received the same medication but the administration sequence was reversed). Pain was assessed using visual analogue scales, and consumption of rescue analgesic. The facial swelling and trismus were evaluated by measuring facial reference distances and maximum mouth opening. There were no significant differences between the two study groups regarding postoperative pain, rescue analgesics consumption, facial swelling and trismus. There was a slightly higher need for rescue analgesics in the experimental group. The preoperative intake of ibuprofen does not seem to reduce pain, facial swelling and trismus after impacted lower third molar removal when compared to the postoperative administration of the same drug.
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Affiliation(s)
- L Aznar-Arasa
- Faculty of Dentistry, University of Barcelona, Spain
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An Evaluation of Patients' Knowledge About Perioperative Information for Third Molar Removal. J Oral Maxillofac Surg 2012; 70:12-8. [DOI: 10.1016/j.joms.2011.06.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 05/07/2011] [Accepted: 06/27/2011] [Indexed: 12/11/2022]
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Poster 02: Pre-Emptive Analgesia: A Randomized Double-Blinded Controlled Study. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Pandit MK, Godhi S, Lall AB. Preoperative intravenous tramadol versus diclofenac for preventing postoperative pain after third molar surgery: a comparative study. J Maxillofac Oral Surg 2011. [PMID: 23204745 DOI: 10.1007/s12663-011-0250-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the analgesic efficacy of a single-dose of preoperative intravenous tramadol versus diclofenac in preventing pain after third molar surgery. MATERIALS AND METHODS Fifty patients undergoing elective third molar surgery were randomly assigned into one of the two groups (25 in each group): Group 1 received diclofenac 75 mg, and Group 2 received tramadol 50 mg intravenously preoperatively before the surgery. After injection of the study drugs, the impacted third molars were removed under local anesthetic agent. RESULTS The difference in postoperative pain was assessed by four primary end-points: pain intensity as measured by a 100 mm visual analogue scale hourly for 12 h, median time to rescue analgesic, postoperative acetaminophen consumption, and patient's global assessment. Throughout the 12 h investigation period, patients reported significantly lower pain intensity scores in the diclofenac versus tramadol group (P = 0.0001, Mann-Whitney U-test). Patients also reported significantly longer median time to rescue analgesic (10 vs. 8 h, P < 0.05, Student t test), lesser postoperative acetaminophen consumption (P < 0.05, Student t test) for the diclofenac versus tramadol group. CONCLUSION Preoperative intravenous diclofenac 75 mg is more effective than tramadol 50 mg in the prevention of postoperative dental pain.
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Affiliation(s)
- Manish Kumar Pandit
- Terna Dental College and Hospital, Nerul, Navi Mumbai, 400706 Maharashtra India
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41
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Tuzuner Oncul AM, Yazicioglu D, Alanoglu Z, Demiralp S, Ozturk A, Ucok C. Postoperative analgesia in impacted third molar surgery: the role of preoperative diclofenac sodium, paracetamol and lornoxicam. Med Princ Pract 2011; 20:470-6. [PMID: 21757939 DOI: 10.1159/000327658] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 03/03/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous (i.v.) paracetamol, diclofenac sodium and lornoxicam (nonsteroidal anti-inflammatory drugs). SUBJECTS AND METHODS Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P (n = 20), group D (n = 20) and group L (n = 20). Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups. RESULTS The groups were comparable for pain scores (p > 0.05). Maximum pain scores were recorded in postoperative 4th h in all groups (group L 22, 14-44 mm; group P 24, 13-43 mm; group D 14, 10-24 mm, p = 0.117). Patients experienced high satisfaction scores which were comparable among groups (group L 85, 75-100 mm; group P 87, 70-95 mm; group D 84, 77-98 mm, p = 0.457). CONCLUSION Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens.
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MESH Headings
- Acetaminophen/administration & dosage
- Acetaminophen/therapeutic use
- Adult
- Analgesics, Non-Narcotic/administration & dosage
- Analgesics, Non-Narcotic/therapeutic use
- Analysis of Variance
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Diclofenac/administration & dosage
- Diclofenac/therapeutic use
- Double-Blind Method
- Female
- Humans
- Male
- Molar, Third/pathology
- Molar, Third/surgery
- Pain Measurement
- Pain, Postoperative/drug therapy
- Patient Satisfaction
- Piroxicam/administration & dosage
- Piroxicam/analogs & derivatives
- Piroxicam/therapeutic use
- Premedication/methods
- Severity of Illness Index
- Statistics, Nonparametric
- Time Factors
- Tooth, Impacted/pathology
- Tooth, Impacted/surgery
- Young Adult
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Lau SL, Chow RLK, Yeung RWK, Samman N. Pre-emptive ibuprofen arginate in third molar surgery: a double-blind randomized controlled crossover clinical trial. Aust Dent J 2010; 54:355-60. [PMID: 20415935 DOI: 10.1111/j.1834-7819.2009.01162.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study evaluated the effectiveness of 400 mg ibuprofen arginate either as a pre-emptive (PRE group) or postoperative (POST group) analgesic using a common dental pain model. METHODS A randomized double-blind crossover clinical trial involving a series of consecutive patients admitted for bilateral third molar surgery. Results were analysed according to the self-reported pain score and the pattern of rescue medication taken. RESULTS The mean pain score ranged from 0.73 to 1.60 for the PRE group and 0.47 to 1.41 for the POST group among 30 included subjects. The mean time point when first rescue medication taken was 7.3 hours and 8.3 hours postoperative, respectively. Nine patients (30 per cent) in the PRE group and 12 patients (40 per cent) in the POST group took no rescue medication. There was no statistically significant difference for all parameters between groups, while a majority (53 per cent) found the drug "good" to "excellent" in both groups. CONCLUSIONS Ibuprofen arginate may be considered effective in reducing surgically induced moderate to severe pain when administered either pre-operatively or postoperatively due to the reported relatively low pain score, less consumption of rescue medication, delayed onset of pain, good number of pain-free patients and a high rating in the global assessment score.
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Affiliation(s)
- S L Lau
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Kaczmarzyk T, Wichlinski J, Stypulkowska J, Zaleska M, Woron J. Preemptive effect of ketoprofen on postoperative pain following third molar surgery. A prospective, randomized, double-blinded clinical trial. Int J Oral Maxillofac Surg 2010; 39:647-52. [DOI: 10.1016/j.ijom.2010.02.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 12/08/2009] [Accepted: 02/09/2010] [Indexed: 11/28/2022]
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Molon V, Kruel CDP, Maioli DT, Caran JZ, Lovison RC. [Evaluation of the analgesic effects of the lumiracoxib compared with placebo in the 24 first postoperative hours]. Rev Col Bras Cir 2010; 36:3-8. [PMID: 20076861 DOI: 10.1590/s0100-69912009000100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 10/22/2008] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To test lumiracoxib used preemptively against a placebo,and to analyse the analgesic administration (dipirona and tramadol) in the 24 first postoperative hours. METHODS Sixty patients undergone to a breast aumentation, under epidural anesthesia, were selected and put randomly in two groups - GI and GII. Sixty minutes before the surgery, it was administered orally, one pill of lumiracoxib 400mg to the 30 GI patients and one pill of placebo to the 30 GII patients. The postoperative pain was evaluated through the visual analogic scale, ranged from 0 (painless) to 10 (most intensive pain), being applied to the patient whenever having pain. For the same scores or under 4, it was administered intravenously 15mg/kg of dipirona up to a maximum of 1g. For scores of 5, 6 or 7, the patient had intravenously 50mg of tramadol.Scores 8 or more were treated intravenously with 0,5 mg/kg of meperidine. RESULTS The scores in GI were significantly lower than the ones obtained in GII within the first 24 hours, with the need of 20% less dipirona and 56% of tramadol in this period of time. In the same way, it was observed that analgesic solicitation for the first time had a delay of 191 minutes in GI in comparison to GII. CONCLUSION The use of lumiracoxib preemptively, was effective in the treatment of postoperative pain, reducing considerably the consume of analgesics, and enlarging the time for the first medication.
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Affiliation(s)
- Vilmar Molon
- Facudade de Medicina, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
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Lee IH, Sung CY, Han JI, Kim CH, Chung RK. The preemptive analgesic effect of ketorolac and propacetamol for adenotonsillectomy in pediatric patients. Korean J Anesthesiol 2009; 57:308-313. [PMID: 30625878 DOI: 10.4097/kjae.2009.57.3.308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both ketorolac and propacetamol are used postoperatively to control mild to moderate pain. This study compared the analgesic efficacy of ketorolac and propacetamol delivered either preoperatively or postoperatively, and assessed the preemptive analgesic effect of ketorolac and propacetamol for adenotonsillectomy. METHODS One hundred and two pediatric patients were divided randomly into four groups. The K1 and P1 groups received ketorolac 1 mg/kg or propacetamol 30 mg/kg after induction, respectively, whereas the K2 and P2 groups received each drug at the end of the operation, respectively. After adenotonsillectomy, we measured the NRS (Numerical Rating Scale), FPS (Faces Pain Scale) and OPS (Objective Pain scale) at 15, 30 and 60 min after arriving at the postanesthesia care unit. RESULTS There were no significant differences in the NRS, FPS and OPS between K1 and K2 and between P1 and P2 for 60 min after operation at the postanesthesia care unit. CONCLUSIONS These results suggest that both ketorolac (1 mg/kg) and propacetamol (30 mg/kg) have no preemptive analgesic effects during 1 hour after adenotonsillectomy.
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Affiliation(s)
- In Hwa Lee
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Chi Yun Sung
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Jong In Han
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Chi Hyo Kim
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Rack Kyung Chung
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
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Affiliation(s)
- Cliff K S Ong
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, National University of Singapure
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Inanoglu K, Gorur S, Akkurt CO, Guven OE, Kararmaz A. The analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair. J Clin Anesth 2008; 19:587-90. [PMID: 18083471 DOI: 10.1016/j.jclinane.2007.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Revised: 06/06/2007] [Accepted: 06/24/2007] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam. DESIGN Prospective, double-blind, randomized clinical investigation. SETTING Operating room and postoperative recovery area. PATIENTS 44 ASA physical status I and II adult male patients undergoing varicocelectomy. INTERVENTIONS Patients were randomized either to receive 8 mg lornoxicam infusion 30 minutes before skin incision, followed by saline infusion immediately after skin closure (group 1), or to receive the identical injections but in reverse order (group 2). All patients received local anesthesia with bupivacaine. MEASUREMENTS Postoperative pain scores were evaluated hourly for the first 8 hours after surgery, then at 12, 16, 20, and 24 hours after surgery, using a 10-cm visual analog scale. Time to first analgesic request and patients' global assessments also were recorded. MAIN RESULTS Patients in group 1 reported significantly lower pain scores (P < 0.05) at all time intervals except at 24 hours and better global assessment (P = 0.001) than did group 2. There were significantly fewer patients in the preemptive group than group 2 who required rescue analgesic within the first 24 hours (0% vs 22.7%; P = 0.024). Mean time to first analgesic request was also significantly longer in the preemptive group (P = 0.001). CONCLUSION Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively.
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Affiliation(s)
- Kerem Inanoglu
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
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Ong CKS, Lirk P, Tan JMH, Sow BWY. The Analgesic Efficacy of Intravenous Versus Oral Tramadol for Preventing Postoperative Pain After Third Molar Surgery. J Oral Maxillofac Surg 2005; 63:1162-8. [PMID: 16094585 DOI: 10.1016/j.joms.2005.04.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to compare the analgesic efficacy of single-dose preoperative intravenous versus oral tramadol for preventing pain after third molar surgery. PATIENTS AND METHODS Seventy-two patients undergoing elective third molar surgery were randomized to receive either intravenous (n = 36) or oral (n = 36) tramadol 50 mg. The intravenous group received an oral placebo capsule followed by intravenous tramadol 50 mg preoperatively. The oral tramadol group received a 50-mg oral tramadol capsule followed by intravenous placebo saline preoperatively. In both groups, a standard intravenous sedation technique was administered and the impacted third molars were removed under local anesthesia. The difference in postoperative pain was assessed by 4 primary end points: hourly pain intensity as measured by a 100-mm visual analog scale for 8 hours, time to rescue analgesic, postoperative acetaminophen consumption, and a 5-point global assessment scale (0 = poor, 1 = fair, 2 = good, 3 = very good, and 4 = excellent). RESULTS Throughout the 8-hour investigation period, patients reported significantly lower pain intensity scores in the intravenous versus oral group (15.9 +/- 9.6 mm versus 36.9 +/- 17.2 mm, P = .03). Patients also reported significantly longer time to rescue analgesic (7.0 hours versus 3.5 hours, P = .00001), lesser postoperative acetaminophen consumption (1,823 +/- 1,266 mg versus 3,558 +/- 1,418 mg, P = .000006), and better global assessment (2.6 +/- 0.9 versus 1.1 +/- 0.8, P = .01) for the intravenous versus oral group. CONCLUSIONS We conclude that preoperative intravenous tramadol is superior to oral tramadol for preventing postoperative pain following third molar surgery. However, it should be noted that there is a difference in the bioavailability between the 2 formulations of up to 30%, which may explain the findings.
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Affiliation(s)
- Cliff K S Ong
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Singapore.
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