Komasawa Nobuyasu, Yamamoto Kayoko, Ito Yuichi, Omori Michi, Ueno Takaaki, Minami Toshiaki
1 Department of Anesthesiology, Osaka Medical College, Osaka, Japan.
2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan.
J Altern Complement Med. 2018 Dec;24(12):1214-1218. doi: 10.1089/acm.2018.0244. Epub 2018 Jul 11.
This study aimed to determine the efficacy of preoperative administration of Jidabokuippo (JDI), a Kampo medicine, in treating postoperative pain after tooth extraction with mandible bone removal.
This single-blind, randomized controlled study was conducted among two groups of adult patients who were scheduled to undergo tooth extraction with mandible bone removal under general anesthesia. Patients were randomly assigned to either the JDI or control group.
Before surgery, the JDI group received JDI (7.5 g), whereas the control group did not receive any treatment. Patients and the evaluator were blinded to the treatment status. At 0, 1, 3, and 24 h after anesthesia recovery, an investigator recorded the severity of postoperative pain and nausea using a numeric rating scale (0, no pain or nausea; 10, worst imaginable pain or nausea). The number of patients who requested nonsteroidal anti-inflammatory drug (NSAID) and that of additional NSAID administration within 24 h from anesthesia recovery, and the time to the first NSAID request from anesthesia recovery was also measured.
The severity of postoperative pain was significantly lower in the JDI group compared with the control group at 3 and 24 h after anesthesia recovery (p < 0.001 each). Both the number of patients requesting NSAID and additional NSAID administration after anesthesia recovery were significantly smaller in the JDI group than in the control group (p = 0.006, p < 0.001). The time to first NSAID request from anesthesia recovery was significantly longer in the JDI group compared with control group (p < 0.001). The severity of nausea did not differ significantly between the groups. No significant side effects related to JDI were noted during the trial.
JDI administration before general anesthesia effectively decreased the severity of postoperative pain after anesthesia recovery in patients who underwent tooth extraction with mandible bone removal.
本研究旨在确定中药制剂积大本朴汤(JDI)术前给药对下颌骨切除拔牙术后疼痛的治疗效果。
本单盲随机对照研究在两组计划在全身麻醉下进行下颌骨切除拔牙的成年患者中开展。患者被随机分配至JDI组或对照组。
手术前,JDI组接受JDI(7.5克),而对照组未接受任何治疗。患者和评估者对治疗状态不知情。在麻醉恢复后0、1、3和24小时,一名研究者使用数字评分量表(0表示无疼痛或恶心;10表示难以想象的最严重疼痛或恶心)记录术后疼痛和恶心的严重程度。还测量了从麻醉恢复起24小时内要求使用非甾体抗炎药(NSAID)的患者数量、额外使用NSAID的次数,以及从麻醉恢复起至首次要求使用NSAID的时间。
麻醉恢复后3小时和24小时,JDI组术后疼痛的严重程度显著低于对照组(均为p<0.001)。JDI组麻醉恢复后要求使用NSAID的患者数量和额外使用NSAID的次数均显著少于对照组(p = 0.006,p<0.001)。JDI组从麻醉恢复起至首次要求使用NSAID的时间显著长于对照组(p<0.001)。两组间恶心的严重程度无显著差异。试验期间未发现与JDI相关的显著副作用。
全身麻醉前给予JDI可有效降低接受下颌骨切除拔牙患者麻醉恢复后的术后疼痛严重程度。