Girotra Charu, Padhye Mukul, Mahajan Pratibha, Savla Siddhi, Nair Aishwarya, Pardeshi Pranay, Tomar Gaurav, Kini Yogesh
Department of Oral and Maxillofacial Surgery, School of Dentistry, D. Y. Patil University, Nerul, Navi Mumbai, India.
Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India.
J Maxillofac Oral Surg. 2023 Mar;22(1):187-195. doi: 10.1007/s12663-022-01806-2. Epub 2022 Oct 13.
Paracetamol is an optimal non-opioid analgesic and holds considerable advantages over NSAIDs in managing post-operative pain. Literature to date doesn't provide substantial documentation of it's efficacy and safety in major oral and maxillofacial surgeries. The study is designed to compare the effectiveness of intravenous paracetamol with diclofenac sodium for controlling post-operative pain and edema in major oral and maxillofacial surgeries.
The double-blind randomised prospective study includes 140 healthy patients with ASA grades I and II. Patients were divided into Group A (1gm paracetamol) and B (75 mg diclofenac sodium), 70 patients each, undergoing similar surgical procedures. VAS and VRS were assessed for pain and thread method for measuring swelling. Mouth opening in space infections was measured with calliper and scale.
Independent samples t-test and chi-square test showed longer pain-free interval, more interval between first and second dose, lesser number of doses required in Group A than Group B (-value < 0.05). Independent samples -test and Mann-Whitney test showed faster resolution of swelling in Group A (-value < 0.05). Independent samples -test showed lesser time taken for resolution of trismus in space infections in Group A (-value < 0.05).
Paracetamol 1 g was found to be an effective analgesic with less adverse effects. It is superior non-opioid analgesic in reducing the intensity of post-operative pain and swelling, also requires less number of doses than diclofenac sodium in major surgeries. Patients treated with paracetamol had better quality of life during post-operative period.
对乙酰氨基酚是一种理想的非阿片类镇痛药，在处理术后疼痛方面比非甾体抗炎药具有显著优势。迄今为止的文献并未提供其在大型口腔颌面外科手术中疗效和安全性的大量记录。本研究旨在比较静脉注射对乙酰氨基酚与双氯芬酸钠在控制大型口腔颌面外科手术后疼痛和水肿方面的有效性。
这项双盲随机前瞻性研究纳入了140例ASA I级和II级的健康患者。患者被分为A组（1克对乙酰氨基酚）和B组（75毫克双氯芬酸钠），每组70例，接受相似的外科手术。采用视觉模拟评分法（VAS）和视觉疼痛评分法（VRS）评估疼痛，并采用丝线法测量肿胀程度。对于间隙感染患者，用卡尺和量表测量其开口度。
独立样本t检验和卡方检验显示，A组的无痛间隔时间更长，首次和第二次给药之间的间隔时间更长，所需剂量比B组少（P值<0.05）。独立样本t检验和曼-惠特尼检验显示，A组肿胀消退更快（P值<0.05）。独立样本t检验显示，A组间隙感染患者张口受限消退所需时间更短（P值<0.05）。
发现1克对乙酰氨基酚是一种有效的镇痛药，副作用较少。它是一种更优的非阿片类镇痛药，可减轻术后疼痛和肿胀的程度，在大型手术中所需剂量也比双氯芬酸钠少。接受对乙酰氨基酚治疗的患者在术后期间的生活质量更好。
