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两种不同镇痛药对下颌骨牵张成骨过程中骨再生影响的比较。

Comparison of the Effects of Two Different Analgesics on Bone Regeneration During Mandibular Distraction Osteogenesis.

作者信息

Sabuncuoglu Fidan Alakus, Ersahan Seyda, Amasyali Mihri, Avunduk Mustafa Cihat

机构信息

Department of Orthodontics, Gulhane Dentistry Faculty, University of Health Sciences, Ankara.

Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul.

出版信息

J Craniofac Surg. 2019 Jan;30(1):e80-e85. doi: 10.1097/SCS.0000000000005000.

Abstract

INTRODUCTION

Mandibular distraction osteogenesis (DO) is frequently used in the management of bone defects and craniofacial deformities, with analgesics commonly administered to relieve acute postoperative pain. This experimental animal study investigated the effects of 2 analgesics, acetaminophen and acemetacin, on bone regeneration after DO.

MATERIALS AND METHODS

This study was conducted with 14 mature male New Zealand rabbits (2.8-3.2 kg) randomized into 2 groups of 7. Mandibular osteotomies were performed under optimal operating conditions, and a custom-made distractor was applied to the mandible of each subject, with distraction initiated after a 5-day latency period at a rate of 1.0 mm/d (2 × 0.5 mm/d) for 10 days. Analgesics were administered via oral gavage during the latency period and for the first 5 days of the distraction period for 10 days in total, with group I receiving acetaminophen (200 mg/kg/d) and group II receiving acemetacin (5 mg/kg/d). Subjects were sacrificed and their mandibles dissected at the end of 4 weeks postoperatively. Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DEXA), and histomorphometric analysis was performed to evaluate the quality of newly formed bone. Paired group comparisons of non-normally distributed numerical variables were made using the Mann-Whitney U test, with a P value of <0.05 considered statistically significant.

RESULTS

No significant differences in BMC and BMD values of intact bone, newly formed bone, or bone around the pin site were observed between the 2 groups. Histometric analysis also indicated acetaminophen and acemetacin to have similar effects on bone regeneration during distraction.

CONCLUSION

Acemetacin may be an alternative to acetaminophen for treating pain associated with DO, given the similarities in the effects of the 2 analgesics on bone regeneration. However, this finding should be supported by further experimental and human studies.

摘要

引言

下颌骨牵张成骨术(DO)常用于治疗骨缺损和颅面畸形,术后常使用镇痛药缓解急性疼痛。本实验动物研究调查了对乙酰氨基酚和阿西美辛这两种镇痛药对下颌骨牵张成骨术后骨再生的影响。

材料与方法

本研究使用14只成熟雄性新西兰兔(体重2.8 - 3.2千克),随机分为两组,每组7只。在最佳手术条件下进行下颌骨截骨术,并为每只实验对象的下颌骨安装定制牵张器,延迟5天后开始牵张,牵张速率为1.0毫米/天(2×0.5毫米/天),持续10天。在延迟期以及牵张期的前5天,共10天时间,通过口服灌胃给予镇痛药,第一组给予对乙酰氨基酚(200毫克/千克/天),第二组给予阿西美辛(5毫克/千克/天)。术后4周结束时处死实验对象并解剖其下颌骨。使用双能X线吸收法(DEXA)测量骨密度(BMD)和骨矿物质含量(BMC),并进行组织形态计量分析以评估新形成骨的质量。对于非正态分布的数值变量,使用曼 - 惠特尼U检验进行组间配对比较,P值<0.05被认为具有统计学意义。

结果

两组之间在完整骨、新形成骨或针道周围骨的BMC和BMD值方面未观察到显著差异。组织计量分析还表明,对乙酰氨基酚和阿西美辛在牵张过程中对骨再生具有相似的作用。

结论

鉴于这两种镇痛药对骨再生的作用相似,阿西美辛可能是治疗下颌骨牵张成骨术相关疼痛的对乙酰氨基酚的替代药物。然而,这一发现需要进一步的实验和人体研究来支持。

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