Research Cluster Periodontology, Oral Implantology, Removable and Implant Prosthodontics, Dental School University Hospital, Faculty of Medicine and Health Sciences, University of Ghent, De Pintelaan 185, 9000, Ghent, Belgium.
PaeCoMeDis Research Group, Dep. Paediatric Dentistry, Dental School University Hospital, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
Clin Oral Investig. 2018 Apr;22(3):1297-1302. doi: 10.1007/s00784-017-2228-6. Epub 2017 Oct 5.
Analgesics are one of the most frequently used medicines. Self-medication and misuse have been described in the literature. The purpose of this study was to document analgesic (mis)use in a population seeking emergency dental treatment.
Patients consulting a dental emergency service were randomly asked to complete a questionnaire on analgesic use, knowledge and information on the analgesics and on their pain history. A photobook was used as an aid to identify products used. Descriptive statistics were combined with chi-square and Mann-Whitney U testing.
Ninety-eight patients were included. Acetaminophen (69.4%) and ibuprofen (65.3%) were the most frequently used products. Nearly half of the subjects (43.9%) combined at least two analgesics. Although 42.9% of subjects were aware of the maximum daily dose, 62.2% of the subjects exceeded this limit, specifically 76.6% of subjects using ibuprofen and 32.4% of subjects using acetaminophen overdosing. Females overdosed significantly more than males. Ingestion on medical advice did not affect the overdose rates significantly. No significant relation was found between the absence of knowledge on the maximum daily dose and actual overdosing. No higher pain reduction was found in patients overdosing analgesics. The average number of days patients experienced pain before consulting the emergency unit was 12. A significant relation was found between the lag time and overdosing.
A large portion of the patients overdosed analgesics. Even prior medical advice did not reduce significantly overdose rates.
Dentists treating emergency cases clearly need to be aware of the high risk and high rates of overdosing analgesics in their patients.
镇痛药是最常使用的药物之一。文献中描述了自我用药和用药不当的情况。本研究的目的是记录在寻求急诊牙科治疗的人群中镇痛药的（不当）使用情况。
随机邀请就诊于牙科急诊服务的患者填写一份关于镇痛药使用、镇痛药知识和信息以及疼痛史的问卷。使用照片集作为识别使用产品的辅助工具。采用描述性统计、卡方检验和曼-惠特尼 U 检验进行数据分析。
共纳入 98 例患者。使用最频繁的产品为对乙酰氨基酚（69.4%）和布洛芬（65.3%）。近一半的受试者（43.9%）至少同时使用两种镇痛药。尽管 42.9%的受试者知晓最大日剂量，但 62.2%的受试者超过了该限制，具体来说，使用布洛芬的受试者中有 76.6%和使用对乙酰氨基酚的受试者中有 32.4%存在用药过量。女性用药过量的比例显著高于男性。在医嘱指导下用药并不会显著影响用药过量率。缺乏关于最大日剂量的知识与实际用药过量之间没有显著关系。用药过量的患者并未获得更高的疼痛缓解效果。在就诊于急诊单位之前，患者平均经历疼痛的天数为 12 天。就诊时间与用药过量之间存在显著关系。
很大一部分患者存在镇痛药用药过量的情况。即使有预先的医学建议，也不能显著降低用药过量率。
治疗急诊病例的牙医显然需要意识到他们的患者存在高风险和高用药过量率的情况。
