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透皮酮洛芬与双氯芬酸贴剂在治疗性拔牙患者中的疗效比较——一项随机前瞻性半口对照研究

Comparison Between Efficacy of Transdermal Ketoprofen and Diclofenac Patch in Patients Undergoing Therapeutic Extraction-A Randomized Prospective Split Mouth Study.

作者信息

Bhargava Darpan, Thomas Shaji, Beena Sivakumar

机构信息

Consultant, Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Center, People's University, Bhopal, India.

Consultant and Head, Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Center, People's University, Bhopal, India.

出版信息

J Oral Maxillofac Surg. 2019 Oct;77(10):1998-2003. doi: 10.1016/j.joms.2019.04.007. Epub 2019 Apr 12.

Abstract

PURPOSE

Postoperative pain control is a significant aspect of patient treatment after an oral and maxillofacial surgical procedure. The use of a transdermal patch is one such method to provide postoperative analgesia. The present study was undertaken to investigate the efficacy of a single-dose transdermal patch of ketoprofen compared with that of diclofenac postoperatively after therapeutic extraction of first premolar teeth for patients undergoing orthodontic treatment.

PATIENTS AND METHODS

A split mouth randomized clinical trial was conducted of 40 patients aged 15 to 25 years who had required therapeutic extraction of both maxillary and mandibular first premolar teeth bilaterally. A single ketoprofen patch was applied for the first and fourth quadrant extraction, and diclofenac patch was applied for the second and third quadrant extraction after atraumatic therapeutic exodontia at 2 consecutive appointments with the patient under local anesthesia. The data were obtained and analyzed using the Student t test and Shapiro-Wilk test using SPSS software (IBM Corp, Armonk, NY).

RESULTS

All 40 patients who had received a single-dose ketoprofen patch had experienced less postoperative pain and did not require a rescue analgesic with a mean visual analog scale (VAS) score of 1.13 ± 0.335 (P < .00001). The patients who had received a diclofenac patch reported comparatively elevated pain scores in the initial 24 hours, with a mean VAS score of 2.0 ± 0.5064 postoperatively, and 20% of the diclofenac treatment arm had required a rescue analgesic. No complications were observed among the patients postoperatively in either treatment arm.

CONCLUSIONS

Both the ketoprofen and diclofenac transdermal patches were effective in achieving postoperative analgesia in patients after therapeutic extraction, with ketoprofen superior to diclofenac as a transdermal medicament.

摘要

目的

术后疼痛控制是口腔颌面外科手术后患者治疗的一个重要方面。使用透皮贴剂是提供术后镇痛的一种方法。本研究旨在调查正畸治疗患者在拔除第一前磨牙进行治疗性拔牙术后,单剂量酮洛芬透皮贴剂与双氯芬酸透皮贴剂的疗效比较。

患者与方法

对40例年龄在15至25岁之间、双侧上颌和下颌第一前磨牙均需进行治疗性拔牙的患者进行了一项双侧口随机临床试验。在局部麻醉下与患者连续两次预约进行无创伤性治疗性拔牙后,第一和第四象限拔牙应用单剂量酮洛芬贴剂,第二和第三象限拔牙应用双氯芬酸贴剂。使用SPSS软件(IBM公司,纽约州阿蒙克)通过学生t检验和夏皮罗-威尔克检验获取并分析数据。

结果

所有40例接受单剂量酮洛芬贴剂的患者术后疼痛较轻,平均视觉模拟评分(VAS)为1.13±0.335,无需使用解救镇痛药(P<0.00001)。接受双氯芬酸贴剂的患者在术后最初24小时疼痛评分相对较高,术后平均VAS评分为2.0±0.5064,20%的双氯芬酸治疗组患者需要使用解救镇痛药。两个治疗组的患者术后均未观察到并发症。

结论

酮洛芬和双氯芬酸透皮贴剂在治疗性拔牙术后患者的术后镇痛中均有效,酮洛芬作为透皮药物优于双氯芬酸。

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