Janarthanan K, Adalarasan S
Reader, Department of OMFS, RMDC & H, Annamalai University, India.
Lecturer, Department of OMFS, RMDC & H, Annamalai University, India.
J Med Life. 2019 Apr-Jun;12(2):150-155. doi: 10.25122/jml-2019-0007.
Pain control during and after any surgical procedure, is extremely essential for the comfort of patients. Pain killers used routinely act by inhibiting cyclooxygenase to control pain and inflammation. Cox-1 is constitutively expressed in most cell types, including platelets, whereas Cox-2 is absent from most healthy tissues but is induced by pro-inflammatory or proliferative stimuli. Cox-1 plays a role in the production of prostaglandins involved in protection of the gastric mucosal layer and thromboxanes (TX) in platelets. Cox-2 generally mediates elevations of prostaglandins associated with inflammation, pain, and pyresis. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are generally nonselective inhibitors of Coxs. This lack of selectivity has been linked to their propensity to cause gastrointestinal side effects. The new Cox-2 selective inhibitors, or coxibs, show the same anti-inflammatory, analgesic, and antipyretic effects as nonselective NSAIDs but are supposed to have reduced side-effect profiles. This study evaluates whether rofecoxib (50 mg) given one hour pre-operatively or the same drug given one hour post-operatively is more effective in controlling the pain and swelling in mandibular third molar surgery.
在任何外科手术期间及术后，疼痛控制对于患者的舒适度极为重要。常规使用的止痛药通过抑制环氧化酶来控制疼痛和炎症。Cox-1在大多数细胞类型中组成性表达，包括血小板，而Cox-2在大多数健康组织中不存在，但可由促炎或增殖刺激诱导产生。Cox-1在参与保护胃黏膜层的前列腺素生成以及血小板中血栓素（TX）的生成中发挥作用。Cox-2通常介导与炎症、疼痛和发热相关的前列腺素升高。阿司匹林和布洛芬等非甾体抗炎药（NSAIDs）通常是Coxs的非选择性抑制剂。这种缺乏选择性与它们引起胃肠道副作用的倾向有关。新型Cox-2选择性抑制剂，即环氧化酶-2抑制剂，显示出与非选择性NSAIDs相同的抗炎、镇痛和解热作用，但据推测其副作用较少。本研究评估术前一小时给予罗非昔布（50毫克）或术后一小时给予相同药物在控制下颌第三磨牙手术中的疼痛和肿胀方面是否更有效。
