Troullos E S, Hargreaves K M, Butler D P, Dionne R A
Clinical Pharmacology Unit, National Institute of Dental Research, National Institute of Health, Bethesda, MD 20892.
J Oral Maxillofac Surg. 1990 Sep;48(9):945-52. doi: 10.1016/0278-2391(90)90007-o.
Pain, swelling, loss of function, and hyperthermia are acute postoperative sequelae of inflammation due to tissue injury during surgical procedures. Pharmacologic strategies for minimizing the clinical manifestations of surgical trauma are often directed toward blocking the formation or inhibiting the effects of the biochemical mediators of acute inflammation. This study compared two nonsteroidal anti-inflammatory drugs (NSAIDs), flurbiprofen and ibuprofen, with a prototype glucocorticoid, methylprednisolone, in two replicate placebo-controlled studies for suppression of inflammation due to the surgical removal of impacted third molars. The results indicate that NSAIDs produce greater initial analgesia than do steroids, whereas steroids result in greater suppression of swelling and less loss of function. Examination of the pooled data from the two studies indicates that NSAID pretreatment results in a modest suppression of swelling in comparison with placebo. These data suggest that the acute analgesic effects of NSAIDs in the oral surgery model are due to suppression of a nociceptive process, presumably prostaglandin formation, rather than a generalized anti-inflammatory effect.
疼痛、肿胀、功能丧失和体温过高是手术过程中组织损伤导致的急性术后炎症后遗症。将手术创伤临床表现降至最低的药理学策略通常旨在阻止急性炎症生化介质的形成或抑制其作用。在两项重复的安慰剂对照研究中，本研究比较了两种非甾体抗炎药（NSAIDs），氟比洛芬和布洛芬，与一种原型糖皮质激素甲泼尼龙，用于抑制因拔除阻生第三磨牙而引起的炎症。结果表明，NSAIDs比类固醇产生更强的初始镇痛作用，而类固醇对肿胀的抑制作用更强且功能丧失更少。对两项研究汇总数据的检查表明，与安慰剂相比，NSAIDs预处理对肿胀有适度的抑制作用。这些数据表明，NSAIDs在口腔手术模型中的急性镇痛作用是由于抑制了伤害感受过程，可能是前列腺素的形成，而不是广泛的抗炎作用。
