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曲马多与酮咯酸用于第三磨牙手术后的疼痛管理比较

Tramadol versus ketorolac for pain management after third molar surgery.

作者信息

Pathi Jugajyoti, Vidya K C, Sangamesh N C

机构信息

Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India.

Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India.

出版信息

Natl J Maxillofac Surg. 2020 Jul-Dec;11(2):236-240. doi: 10.4103/njms.NJMS_78_17. Epub 2020 Dec 16.

DOI:10.4103/njms.NJMS_78_17
PMID:33897187
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8051645/
Abstract

OBJECTIVES

To compare the analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery.

METHODOLOGY

Two hundred patients in the age group of 18-40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups (100 in each group) and underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary end points: pain intensity being measured hourly by Wong-Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient's global assessment.

RESULTS

Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug-related complications were mild and did not require any investigation.

CONCLUSION

The result of the present study shows that preoperative IV ketorolac 30 mg is more effective than tramadol 50 mg for postoperative pain following third molar surgery.

摘要

目的

比较术前静脉注射酮咯酸与曲马多预防下颌第三磨牙手术后疼痛的镇痛效果。

方法

将200例年龄在18 - 40岁、无症状的下颌阻生磨牙患者随机分为两组(每组100例),在局部麻醉下接受第三磨牙手术。第一组术前静脉注射30毫克酮咯酸,第二组术前静脉注射50毫克曲马多。通过五个主要终点评估术后疼痛差异:采用面部表情疼痛评分量表每小时测量一次疼痛强度,持续6小时;镇痛起效时间;作用持续时间;消耗的镇痛药总数;以及患者整体评估。

结果

在整个6小时的调查期内,与曲马多组相比,酮咯酸组患者报告的疼痛强度评分显著更低、作用持续时间更长、术后镇痛药消耗量更少且整体评估更好。除镇痛起效时间外,酮咯酸组患者在所有参数方面均显著优于曲马多组。所有与药物相关的并发症均较轻微,无需任何检查。

结论

本研究结果表明,术前静脉注射30毫克酮咯酸在预防下颌第三磨牙手术后疼痛方面比50毫克曲马多更有效。

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本文引用的文献

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Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery--a prospective randomized study.静脉注射曲马多与酮咯酸预防第三磨牙手术后疼痛的比较研究——一项前瞻性随机研究。
J Craniomaxillofac Surg. 2014 Jul;42(5):629-33. doi: 10.1016/j.jcms.2013.09.004. Epub 2013 Sep 25.
2
Analgesic and adjuvant anesthetic effect of submucosal tramadol after mandibular third molar surgery.下颌第三磨牙手术后黏膜下注射曲马多的镇痛及辅助麻醉效果
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Mar;117(3):e249-54. doi: 10.1016/j.oooo.2012.05.015. Epub 2012 Sep 12.
3
Pre-emptive analgesia with the combination of tramadol plus meloxicam for third molar surgery: a pilot study.曲马多联合美洛昔康用于第三磨牙手术的超前镇痛:一项初步研究。
Br J Oral Maxillofac Surg. 2012 Oct;50(7):673-7. doi: 10.1016/j.bjoms.2011.12.003. Epub 2012 Jan 4.
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Preoperative diclofenac sodium and tramadol for pain relief after bimaxillary osteotomy.术前使用双氯芬酸钠和曲马多缓解双颌截骨术后疼痛。
J Oral Maxillofac Surg. 2007 Dec;65(12):2453-8. doi: 10.1016/j.joms.2007.06.622.
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Tramadol administered in a combination of routes for reducing pain after removal of an impacted mandibular third molar.曲马多通过多种途径联合给药以减轻下颌阻生第三磨牙拔除术后的疼痛。
J Oral Maxillofac Surg. 2007 Aug;65(8):1633-9. doi: 10.1016/j.joms.2006.06.267.
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Pre-emptive analgesic effect of tramadol after mandibular third molar extraction: a pilot study.曲马多在下颌第三磨牙拔除术后的超前镇痛效果:一项初步研究。
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Assessing postoperative discomfort after third molar surgery: a prospective study.评估第三磨牙手术后的术后不适:一项前瞻性研究。
J Oral Maxillofac Surg. 2007 May;65(5):901-17. doi: 10.1016/j.joms.2005.12.046.
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J Oral Maxillofac Surg. 2005 Aug;63(8):1130-7. doi: 10.1016/j.joms.2005.04.004.
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Int J Oral Maxillofac Surg. 2004 Apr;33(3):274-8. doi: 10.1006/ijom.2003.0515.