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评估是否需要开具阿片类药物来控制不同牙周/口腔手术后的术后疼痛。

Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries.

机构信息

Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, CO.

Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, TX.

出版信息

J Periodontol. 2021 Jul;92(7):1030-1035. doi: 10.1002/JPER.20-0315. Epub 2020 Nov 5.

Abstract

BACKGROUND

To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type.

METHODS

Patients undergoing surgical procedures were asked to complete a pain questionnaire at four time points: 1) before surgery 2) first dose of analgesic at home, 3) 24 hours postoperatively, and 4) 72 hours postoperatively. The questionnaire consisted of numerical and descriptive scales to describe the perceived pain.

RESULTS

A total of 198 patients completed the questionnaire. All surgical procedures were grouped into five major categories: bone augmentation procedures (11% BAP), teeth extractions (26% EXT), surgical implant placement (25% IP), mucogingival surgeries (21% MGS), and pocket elimination procedures (17%). IP surgery was associated with significantly less pain compared with MGS and EXT (P <0.05). There was a statistically significant difference for taking any medication based on type of surgical procedure at 24 hours (P <0.05).

CONCLUSIONS

IP is associated with significantly lower perceived pain compared with EXT and MGS surgery. Analgesic consumption was generally parallel to pain perception. A considerable number of patients elected to control the post-surgical pain using OTC medication up to 72 hours. Periodontal/oral surgery procedures vary in the amount of perceived postoperative pain. Tailoring postoperative medications to the type of periodontal/oral surgery performed will help prevent overprescribing of opioids.

摘要

背景

为了确定不同类型牙周/口腔手术患者术后疼痛的感知程度,以及患者对疼痛管理的选择(非处方 (OTC) 药物与阿片类药物),并根据手术类型进行差异比较。

方法

接受手术的患者在四个时间点完成疼痛问卷:1)手术前;2)在家服用第一剂镇痛药时;3)术后 24 小时;4)术后 72 小时。问卷包括数字和描述性量表,用于描述感知到的疼痛。

结果

共有 198 名患者完成了问卷。所有手术程序分为五类:骨增量程序(11% BAP)、拔牙(26% EXT)、手术种植体放置(25% IP)、黏骨膜手术(21% MGS)和牙周袋消除手术(17%)。与 MGS 和 EXT 相比,IP 手术的疼痛明显较轻(P<0.05)。根据手术类型,24 小时服用任何药物存在统计学差异(P<0.05)。

结论

与 EXT 和 MGS 手术相比,IP 与明显较低的感知疼痛相关。镇痛药的使用与疼痛感知大致平行。相当多的患者选择在术后 72 小时内使用 OTC 药物来控制术后疼痛。牙周/口腔手术的术后疼痛感知程度存在差异。根据所进行的牙周/口腔手术类型定制术后药物治疗,有助于预防阿片类药物的过度处方。

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