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多日镇痛的评价:依托考昔的双盲、随机对照试验,使用术后第三磨牙拔出牙科疼痛模型。

Evaluation of multiday analgesia with etoricoxib in a double-blind, randomized controlled trial using the postoperative third-molar extraction dental pain model.

机构信息

Jean Brown Research Inc., Salt Lake City, UT 84049, USA.

出版信息

Clin J Pain. 2013 Jun;29(6):492-8. doi: 10.1097/AJP.0b013e318260c144.


DOI:10.1097/AJP.0b013e318260c144
PMID:23247002
Abstract

OBJECTIVE: To evaluate the analgesic effects of etoricoxib and comparator agents on the second and third days after oral surgery. METHODS: There were 588 patients initially randomized to placebo (n=46), etoricoxib 120 mg once daily (n=97), etoricoxib 90 mg once daily (n=191), ibuprofen 600 mg every 6 hours (n=192), and acetaminophen 600 mg/codeine 60 mg (A/C) every 6 hours (n=62) after third-molar extraction (≥2, ≥1 impacted) in a double-blind controlled trial. Patients were allowed flexible dosing on days 2 and 3; 46, 96, 190, 192, and 56 patients on placebo, etoricoxib 120 mg, etoricoxib 90 mg, ibuprofen, and A/C, respectively, continued to Day 2 of the study. Outcomes included Average and Worst Recall Pain Assessments (0 to 10 scale) and Global Assessments of Study Medication (0 to 4 scale). Rescue medication (acetaminophen 325 mg up to 4 times daily) usage was evaluated. Adverse experiences were collected and evaluated. RESULTS: Average Pain Recall scores were lower than placebo for all active treatments on Day 2 but only for etoricoxib 120 and 90 mg on Day 3. Worst Pain Recall scores were lower than placebo for only etoricoxib 120 and 90 mg on Day 2; all treatment groups were similar on day 3. Rescue medicine was used on day 2 in 57% of placebo patients, whereas use in active treatments ranged from 18% to 23%; for Day 3, rescue was used in 22% of placebo patients, whereas use in active treatments ranged from 14% to 20%. Differences in mean Patient's Global Assessment of Study Medication scores were significant for etoricoxib versus placebo (P<0.001) and for etoricoxib versus A/C (P<0.010). Nausea and vomiting were among the most common adverse events with higher frequency in the A/C group. CONCLUSIONS: Pain control was most favorable for the etoricoxib doses and ibuprofen. Global Assessments of Study Medication continued to differentiate the treatments and demonstrated greater efficacy for etoricoxib on Days 2 and 3 compared with placebo and A/C (NCT00694369).

摘要

目的:评估依托考昔和对照药物在口腔手术后第二天和第三天的镇痛效果。

方法:共有 588 例患者最初随机分配至安慰剂组(n=46)、依托考昔 120mg 每日一次组(n=97)、依托考昔 90mg 每日一次组(n=191)、布洛芬 600mg 每 6 小时一次组(n=192)和扑热息痛 600mg/可待因 60mg(A/C)每 6 小时一次组(n=62),用于接受下颌第三磨牙(≥2 个,≥1 个阻生)拔除的双盲对照试验。在第 2 天和第 3 天,患者可灵活使用药物;分别有 46、96、190、192 和 56 例患者继续接受安慰剂、依托考昔 120mg、依托考昔 90mg、布洛芬和 A/C 治疗至研究的第 2 天。结局指标包括平均和最差回忆疼痛评估(0 至 10 分)和研究药物总体评估(0 至 4 分)。评估了急救药物(扑热息痛 325mg 每日最多 4 次)的使用情况。收集并评估了不良反应事件。

结果:在第 2 天,与安慰剂相比,所有活性治疗组的平均疼痛回忆评分均较低,但仅依托考昔 120mg 和 90mg 在第 3 天如此;在第 2 天,只有依托考昔 120mg 和 90mg 组的最差疼痛回忆评分低于安慰剂组;第 3 天,所有治疗组均相似。在第 2 天,安慰剂组有 57%的患者使用了急救药物,而在活性治疗组中,使用比例为 18%至 23%;在第 3 天,安慰剂组有 22%的患者使用了急救药物,而在活性治疗组中,使用比例为 14%至 20%。依托考昔与安慰剂相比(P<0.001)和依托考昔与 A/C 相比(P<0.010),患者对研究药物总体评估的差异有统计学意义。恶心和呕吐是最常见的不良反应,A/C 组发生频率更高。

结论:依托考昔和布洛芬的止痛效果最佳。对研究药物的总体评估继续区分了这些治疗方法,并显示依托考昔在第 2 天和第 3 天的疗效优于安慰剂和 A/C(NCT00694369)。

相似文献

[1]
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[2]
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[3]
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[6]
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[10]
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引用本文的文献

[1]
The Effects of Non-Steroidal Anti-Inflammatory Drugs Used for Orthodontic Pain Management on Tooth Movement: A Comprehensive Review of the Literature.

J Clin Med. 2025-4-23

[2]
Comparing pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life: a prospective quasi-experimental study.

Clin Oral Investig. 2024-3-15

[3]
Comparison of preemptive etoricoxib and dexamethasone in third molar surgery - a randomized controlled clinical trial of patient-reported and clinical outcomes.

Clin Oral Investig. 2023-9

[4]
Does low dose of etoricoxib play pre-emptive analgesic effect in third molar surgery? A randomized clinical trial.

BMC Oral Health. 2021-9-23

[5]
Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis.

Behav Neurol. 2021

[6]
Effect of preemptive dexamethasone and etoricoxib on postoperative period following impacted third molar surgery - a randomized clinical trial.

Med Oral Patol Oral Cir Bucal. 2019-11-1

[7]
Efficacy and safety of selective COX-2 inhibitors for pain management after third molar removal: a meta-analysis of randomized clinical trials.

Clin Oral Investig. 2019-4-23

[8]
The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.

PLoS One. 2015-6-8

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