通过天赋选择的新型给药途径而非口服途径进行疼痛控制。
Pain Control by Novel Route of Gifted Choice Against Peroral Route.
作者信息
Sharma Kartikeya, Sharma Pallavi, Gupta Ashish, Bansal Pankaj, Behera Shivprasad
机构信息
Department of Oral and Maxillofacial Surgery, SR College of Dental Sciences and Research, Faridabad, India.
2Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India.
出版信息
J Maxillofac Oral Surg. 2019 Sep;18(3):339-344. doi: 10.1007/s12663-017-1001-3. Epub 2017 Mar 4.
INTRODUCTION
Pain after surgical extraction of third molars has been a nemesis for oral surgeons with clinicians, thus striving for an analgesic modality. NSAIDs are among the most widely used therapeutic classes of analgesics. Transbuccal diclofenac sodium patches have been developed as an innovative drug delivery system using buccal mucosa as a gifted choice, hence overcoming first pass metabolism and offering the advantage of sustained drug delivery with reduced incidence of systemic adverse effects.
AIM
A comparative study was conducted to evaluate the efficacy of diclofenac sodium for pain control, administered via the far-fetched and gifted novel route through the transbuccal patch and by ever popular per oral route and also to assess the adverse effects vis-à-vis for transbuccal diclofenac patch and oral diclofenac following extraction of bilaterally symmetrical impacted mandibular third molars under local anaesthesia.
METHODOLOGY
Thirty healthy subjects of both the sexes in the age of 12 to 50 years with asymptomatic bilaterally symmetrical mandibular third molars underwent extraction under LA. It is a split-mouth study, i.e. after the extraction of tooth on one side, diclofenac sodium (50 mg) via oral route was given and then in another visit, when the same patient is comfortable and asymptomatic, extraction on contralateral side was executed and transbuccal patched diclofenac sodium (20 mg) was applied. Pain was measured on visual analog scale and verbal rating scale by the patient for 3 days and adverse effects if any were noted.
RESULT
Statistical analysis showed that transbuccal diclofenac sodium was significantly efficacious when compared to the drug administered orally. Also, statistically significant results were obtained in percentage reduction in pain from 1st to 3rd postoperative day in transbuccal group. No significant difference is seen for adverse reactions.
CONCLUSION
Transbuccal diclofenac sodium patch is more efficacious and can be used for pain control.
引言
拔除第三磨牙后的疼痛一直是口腔外科医生和临床医生的一大难题，因此一直在寻求一种镇痛方法。非甾体抗炎药是使用最广泛的一类镇痛药。经颊双氯芬酸钠贴片已被开发为一种创新的给药系统，利用颊黏膜作为理想的选择，从而克服首过代谢，并具有持续给药的优势，同时降低全身不良反应的发生率。
目的
进行一项比较研究，以评估双氯芬酸钠通过经颊贴片这种新奇且理想的新途径和常用的口服途径给药对疼痛控制的疗效，并评估在局部麻醉下双侧对称的下颌阻生第三磨牙拔除术后经颊双氯芬酸钠贴片和口服双氯芬酸钠的不良反应。
方法
30名年龄在12至50岁之间、双侧对称下颌第三磨牙无症状的健康受试者在局部麻醉下接受拔牙。这是一项双侧对照研究，即一侧牙齿拔除后，给予口服双氯芬酸钠（50毫克），然后在另一次就诊时，当同一名患者感觉舒适且无症状时，对另一侧进行拔牙，并应用经颊贴片双氯芬酸钠（20毫克）。患者在3天内通过视觉模拟量表和语言评定量表测量疼痛，并记录任何不良反应。
结果
统计分析表明，与口服给药相比，经颊双氯芬酸钠的疗效显著。此外，经颊组术后第1天至第3天疼痛减轻的百分比也获得了具有统计学意义的结果。不良反应方面未见显著差异。
结论
经颊双氯芬酸钠贴片更有效，可用于疼痛控制。
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