Xie Long, Yang Rong-Tao, Lv Kun, Zhou Hai-Hua, Li Zhi
Attending Physician, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, and Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Associate Professor, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, and Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
J Oral Maxillofac Surg. 2020 Jan;78(1):75.e1-75.e6. doi: 10.1016/j.joms.2019.09.022. Epub 2019 Sep 27.
This study aimed to compare the pre-emptive analgesia of oral celecoxib with oral acetaminophen after surgical removal of the mandibular third molars.
A randomized, double-blinded, placebo-controlled clinical trial was conducted to examine patients presenting with a mandibular third molar for extraction under local anesthesia. The participants were randomized to receive a preoperative oral dose of celecoxib or acetaminophen as the predictor variable. The primary outcome variable was postoperative pain measured on a visual analog scale at different time points. The secondary outcome variable was the amount of postoperative analgesic medication taken in both groups. Statistical analyses included descriptive statistics, the t test, and the Pearson χ test. Significance was set at P < .05. The overall survival (interval to the first intake of ibuprofen) of the patients in each group was evaluated using Kaplan-Meier curves and log-rank analyses.
Sixty participants were randomly divided into either the celecoxib group or acetaminophen group. The postoperative pain scores in the celecoxib group were significantly lower than those in the acetaminophen group at 4, 6, 8, and 12 hours (P = .008, P = .001, P = .021, and P = .011, respectively). The number of patients who did not require analgesics in the celecoxib group was less than that in the acetaminophen group (P = .018). The average amount of rescue analgesic medication in the celecoxib group (0.6 ± 0.8 dose) was significantly lower than that in the acetaminophen group (1.3 ± 1.0 doses) (P = .002). The Kaplan-Meier curve indicated that celecoxib resulted in long-term survival of the patients who did not receive rescue analgesic medication (P = .0055).
Celecoxib exhibits a significant pre-emptive analgesic effect, thereby reducing the use of postoperative analgesics after removal of the third molar.
本研究旨在比较下颌第三磨牙拔除术后口服塞来昔布与口服对乙酰氨基酚的超前镇痛效果。
进行一项随机、双盲、安慰剂对照临床试验，以检查在局部麻醉下拔除下颌第三磨牙的患者。参与者被随机接受术前口服塞来昔布或对乙酰氨基酚作为预测变量。主要结局变量是在不同时间点用视觉模拟量表测量的术后疼痛。次要结局变量是两组术后服用的镇痛药物量。统计分析包括描述性统计、t检验和Pearson χ检验。显著性设定为P < 0.05。使用Kaplan-Meier曲线和对数秩分析评估每组患者的总体生存期（至首次服用布洛芬的间隔时间）。
60名参与者被随机分为塞来昔布组或对乙酰氨基酚组。塞来昔布组术后4、6、8和12小时的疼痛评分显著低于对乙酰氨基酚组（分别为P = 0.008、P = 0.001、P = 0.021和P = 0.011）。塞来昔布组中不需要镇痛药的患者数量少于对乙酰氨基酚组（P = 0.018）。塞来昔布组的平均急救镇痛药物用量（0.6±0.8剂）显著低于对乙酰氨基酚组（1.3±1.0剂）（P = 0.002）。Kaplan-Meier曲线表明，塞来昔布使未接受急救镇痛药物的患者获得长期生存期（P = 0.0055）。
塞来昔布具有显著的超前镇痛作用，从而减少了第三磨牙拔除术后的镇痛药使用。
