Kale Saurabh Gajanan, Shetty Akshay, Moin Ayesha, Archana T S, Kumar Praveen, Bagga Vivek
Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
Ann Maxillofac Surg. 2020 Jul-Dec;10(2):312-319. doi: 10.4103/ams.ams_252_19. Epub 2020 Aug 16.
Postoperative pain following third molar removal is one of the most common and unpleasant complications encountered in routine surgical practice. Various methods have been advocated to minimize the postoperative pain: preemptive analgesia is one of those found to be effective.
The aim of this study was to compare the preemptive analgesic efficacy of Dextromethorphan (DM) and Ibuprofen in the third molar surgeries.
Thirty-six patients reporting to our institution were included in the study. Patients were randomized into three groups of 12 patients each to receive either DM 30 mg, ibuprofen 100 mg, or placebo in the form of multivitamin syrup, 90 min before the procedure. The difficulty of removal of the teeth was assessed using Campbell difficulty score. The study objectives were to evaluate the time elapsed since surgery after which the patient took their first dose of aceclofenac, to evaluate the postoperative pain using visual analog scale score, and to record the number of aceclofenac tablets consumed postoperatively.
The results of the study revealed that preemptive DM was significantly better than ibuprofen and placebo in the duration of time that elapsed before the patients consumed their first analgesic postoperatively. Preemptive DM also reduced the total number of aceclofenac tablets consumed on the day of surgery and on the 1 postoperative day, but the difference was not statistically significant. Between the two drugs, DM is better suited for providing preemptive analgesia. No side effects at a dose of 30 mg of DM were noted in any of the patients.
DM premedication is a viable preemptive analgesic in reducing postoperative pain.
拔除第三磨牙后的术后疼痛是常规外科手术中最常见且令人不适的并发症之一。人们提倡采用各种方法来尽量减轻术后疼痛:超前镇痛就是其中一种被发现有效的方法。
本研究旨在比较右美沙芬(DM)和布洛芬在第三磨牙手术中的超前镇痛效果。
本研究纳入了36名到我院就诊的患者。患者被随机分为三组,每组12人,分别在手术前90分钟接受30毫克DM、100毫克布洛芬或多种维生素糖浆形式的安慰剂。使用坎贝尔难度评分评估牙齿拔除的难度。研究目的包括评估患者术后服用第一剂醋氯芬酸的时间间隔、使用视觉模拟量表评分评估术后疼痛,以及记录术后服用醋氯芬酸片剂的数量。
研究结果显示,在术后患者服用第一剂镇痛药之前的时间持续方面,超前给予DM明显优于布洛芬和安慰剂。超前给予DM还减少了手术当天和术后第1天服用醋氯芬酸片剂的总数,但差异无统计学意义。在这两种药物之间,DM更适合提供超前镇痛。在任何患者中均未观察到30毫克DM剂量的副作用。
DM预处理是减轻术后疼痛的一种可行的超前镇痛方法。