Conservative Dentistry Department, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Pharmacology Department, Basic Health Sciences Institute, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Clin Oral Investig. 2021 Mar;25(3):875-882. doi: 10.1007/s00784-020-03374-6. Epub 2020 Jul 10.
The study aimed to compare the acetaminophen administration efficacy or its combination with codeine for pain control in acute apical abscesses cases.
Thirty-nine patients who sought emergency treatment in the Faculty of Dentistry of the Federal University of Rio Grande do Sul were included, all of them with acute apical abscess diagnosis. These patients were divided into two groups: acetaminophen group-prescription of acetaminophen (1000 mg) and acetaminophen-codeine group-prescription of acetaminophen (1000 mg) + codeine (30 mg), both with oral intake every 6 h for 3 days. The pain scores were recorded by the patients on their own at 6, 12, 24, 48, and 72 h after finishing clinical assistance, by filling a pain evolution journal, containing a visual analogue scale (VAS). Student t test was conducted to investigate different mean ages between groups 1 and 2. A comparison of weight and means of initial pain scores between groups was carried out using the Mann-Whitney U test. Chi-square test was performed to compare gender, affected tooth, education, initial swelling, and frequency of adverse effect between test and control groups. Mann-Whitney U test was applied to compare groups in the same period. Friedman's test was used to compare results from the same group over time.
Both groups showed score reduction over time (P < 0.05). Paracetamol-codeine group showed significant pain score reduction at 48 h registers when compared to baseline and at 6 h scores (P < 0.05). Further, pain scores at 72 h were significantly lower, when compared to the baseline, at 6 h, and at 12 h scores (P < 0.05). Acetaminophen group showed significant pain score reduction observed at 72 h, when compared to the baseline and at 6 h scores (P < 0.05). There were no significant differences in pain score reduction over time between groups (P > 0.05). There was no difference between the groups regarding the frequency of adverse reactions (P > 0.05).
Both medications were effective for pain control in acute apical abscess cases. The findings might have inferred in pain control of acute apical abscess associated pain in patients who used an antibiotic drug. External validity of the findings for acute apical abscess cases with no need for an antibiotic prescription is uncertain.
This paper suggests acetaminophen 1000 mg can be used for pain control in the treatment of acute apical abscess associated with systemic manifestation.
本研究旨在比较扑热息痛给药疗效或其与可待因联合用于治疗急性根尖脓肿病例的止痛效果。
共纳入 39 名在南里奥格兰德州联邦大学牙科学院急诊就诊的患者，所有患者均诊断为急性根尖脓肿。将这些患者分为两组：扑热息痛组（处方扑热息痛 1000mg）和扑热息痛-可待因组（处方扑热息痛 1000mg+可待因 30mg），均为口服，每 6 小时一次，连用 3 天。患者在完成临床治疗后，自行在 6、12、24、48 和 72 小时通过填写疼痛演变日记来记录疼痛评分，日记中包含视觉模拟量表（VAS）。采用 Student t 检验比较组 1 和组 2 之间的不同平均年龄。采用 Mann-Whitney U 检验比较两组之间的体重和初始疼痛评分均值。采用卡方检验比较试验组和对照组之间的性别、受累牙、教育程度、初始肿胀和不良反应频率。采用 Mann-Whitney U 检验比较同一时期的组间差异。采用 Friedman 检验比较同一组不同时间的结果。
两组的评分均随时间的推移而降低（P<0.05）。与基线和 6 小时评分相比，扑热息痛-可待因组在 48 小时的评分显著降低（P<0.05）。此外，与基线相比，72 小时的评分在 6 小时和 12 小时的评分显著降低（P<0.05）。与基线和 6 小时的评分相比，扑热息痛组在 72 小时的评分显著降低（P<0.05）。两组间疼痛评分随时间的降低无显著差异（P>0.05）。两组不良反应的频率无显著差异（P>0.05）。
两种药物均能有效控制急性根尖脓肿病例的疼痛。本研究结果可能暗示在使用抗生素药物的急性根尖脓肿相关疼痛患者的疼痛控制中具有一定作用。对于不需要抗生素处方的急性根尖脓肿病例，研究结果的外部有效性尚不确定。
本研究提示 1000mg 扑热息痛可用于治疗伴有全身症状的急性根尖脓肿相关疼痛。
