Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brazil.
J Periodontol. 2011 Sep;82(9):1238-44. doi: 10.1902/jop.2011.100682. Epub 2011 Jan 14.
Postoperative pain is an adverse effect of periodontal surgeries and may therefore be prevented or minimized. This study was conducted to evaluate the clinical efficacy of two selective cyclooxygenase-2 inhibitors, celecoxib and etoricoxib, on pain prevention after periodontal surgery.
For this double-masked, parallel-group, placebo-controlled, and randomized clinical trial, 56 open-flap debridement surgeries were performed. The groups received three different protocols 1 hour before surgery: 1) 200 mg celecoxib (and another 200 mg 12 hours after the first dose); 2) 120 mg etoricoxib; or 3) placebo. Pain intensity and discomfort were assessed up to 2 days after surgery using the visual analog scale and the four-point verbal rating scale, respectively. Patients were instructed to take 750 mg acetaminophen as a rescue medication if necessary.
Pain intensity levels in the etoricoxib group were lower than in the placebo group at the 2-, 3-, 4-, 5-, 6-, and 7-hour periods after surgery (Kruskal-Wallis test; P <0.05). There was no statistically significant difference between celecoxib and etoricoxib. Discomfort in the celecoxib group was significantly lower than in the placebo group only at the 3-hour period (P = 0.03). Rescue medication intake was significantly less frequent in the etoricoxib group than in the placebo and celecoxib groups (analysis of variance; P = 0.009).
It was concluded that a single etoricoxib dose is not superior to two split doses of celecoxib when used for pain prevention after open-flap debridement surgery.
术后疼痛是牙周手术的一种不良反应,因此可以预防或减轻。本研究旨在评估两种选择性环氧化酶-2 抑制剂(塞来昔布和依托考昔)在预防牙周手术后疼痛方面的临床疗效。
本双盲、平行组、安慰剂对照、随机临床试验共进行了 56 例牙周翻瓣清创术。三组患者分别在术前 1 小时接受以下三种不同方案:1)200mg 塞来昔布(首剂后 12 小时再服 200mg);2)120mg 依托考昔;或 3)安慰剂。使用视觉模拟评分法和四点口述评分法分别在术后 2 天内评估疼痛强度和不适程度。患者在必要时可服用 750mg 对乙酰氨基酚作为解救药物。
依托考昔组在术后 2、3、4、5、6 和 7 小时的疼痛强度水平低于安慰剂组(Kruskal-Wallis 检验;P<0.05)。塞来昔布组与依托考昔组之间无统计学差异。塞来昔布组在术后 3 小时的不适程度明显低于安慰剂组(P=0.03)。依托考昔组的解救药物摄入频率明显低于安慰剂组和塞来昔布组(方差分析;P=0.009)。
单次依托考昔剂量并不优于塞来昔布两次分剂量,用于预防牙周翻瓣清创术后疼痛。