Ansari Amir Houshang, Shooshtari Zahra, Alipour Mohammad, Abrishami Majid Hosseini, Shirzadeh Alireza, Samieirad Sahand
Dentist, Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Dentistry Student, Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
J Oral Maxillofac Surg. 2022 Feb;80(2):240-247. doi: 10.1016/j.joms.2021.08.151. Epub 2021 Aug 20.
The aim of this study was to assess the effect of preoperative administration of oral montelukast on the amount of postoperative pain following bimaxillary orthognathic surgery.
All healthy skeletal class III deformity candidates for bimaxillary orthognathic surgery were included in this triple-blind randomized clinical trial. The subjects were randomly divided into placebo and montelukast groups. One hour before the surgery, a 10 mL of apple juice was given to each and every patient; however, a 10 mg tablet of montelukast was dissolved in the juice for the intervention group. All operations were performed by the same surgical team, under the same general anesthesia protocols. The outcome variable was the amount of postoperative pain (1-, 3-, 6-, 12-, 18-, and 24-hour intervals) which was measured during the first 24 hours using a Visual Analog Scale. For statistical analysis, the significance level was set at 0.05 using SPSS 23.
A total of 60 consecutive patients, comprising 31 females (51.7%) and 29 males (48.3%) with an average age of 25.2 ± 2.2 were recruited. The average surgical duration was 193 ± 28.0 minutes. In general, pain intensity exhibited an increasing trend from the first hour postoperatively, reaching its peak in the 12th hour and decreasing thereafter. Nevertheless, the average amount of pain was significantly higher in the placebo group compared with the montelukast group, in all the studied time intervals (P < .05). The number of patients who required postoperative opioid analgesics was significantly higher in the placebo group compared to the montelukast group (P = .024). Moreover, the duration of surgery had a direct and significant effect on the postoperative pain intensity (P < .001).
It might be concluded that preoperative administration of montelukast is effective in reducing postoperative pain following bimaxillary orthognathic surgery. Further studies are necessary for more relevancy.
本研究旨在评估术前口服孟鲁司特对双颌正颌手术后疼痛程度的影响。
本三盲随机临床试验纳入了所有健康的双颌正颌手术候选Ⅲ类骨骼畸形患者。受试者被随机分为安慰剂组和孟鲁司特组。手术前1小时，给每位患者服用10毫升苹果汁；然而，干预组将10毫克孟鲁司特片溶解在果汁中。所有手术均由同一手术团队在相同的全身麻醉方案下进行。观察变量为术后疼痛程度（术后1、3、6、12、18和24小时），在前24小时内使用视觉模拟评分法进行测量。采用SPSS 23进行统计分析，显著性水平设定为0.05。
共纳入60例连续患者，其中31例女性（51.7%），29例男性（48.3%），平均年龄25.2±2.2岁。平均手术时间为193±28.0分钟。一般来说，疼痛强度从术后第1小时开始呈上升趋势，在第12小时达到峰值，随后下降。然而，在所有研究的时间间隔内，安慰剂组的平均疼痛程度显著高于孟鲁司特组（P<.05）。与孟鲁司特组相比，安慰剂组术后需要使用阿片类镇痛药的患者数量显著更高（P = .024）。此外，手术时间对术后疼痛强度有直接且显著的影响（P<.001）。
可以得出结论，术前服用孟鲁司特对减轻双颌正颌手术后的疼痛有效。为了更具相关性，还需要进一步研究。
