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预防性单次静脉注射右旋酮洛芬是否能减少正颌手术后的疼痛和肿胀?一项前瞻性、随机、双盲临床试验。

Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial.

机构信息

Erciyes University, Faculty of Dentistry Departments of Oral and Maxillofacial 38039, Surgery, Kayseri, Turkey

出版信息

Med Oral Patol Oral Cir Bucal. 2023 May 1;28(3):e199-e207. doi: 10.4317/medoral.24852.

Abstract

BACKGROUND

The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery.

MATERIAL AND METHODS

The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test.

RESULTS

The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05).

CONCLUSIONS

Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.

摘要

背景

本研究旨在评估单次静脉给予右酮洛芬预防镇痛对双颌手术术后疼痛和减轻肿胀的效果。

材料和方法

作者设计了一项前瞻性、随机、双盲队列研究。患有 III 类错颌的患者被随机分为两组。治疗组在切开前 30 分钟给予 50mg 静脉右酮洛芬托烷司琼,而安慰剂组在切开前 30 分钟给予静脉无菌生理盐水。主要预测变量是治疗组。主要结局是疼痛、肿胀和 24 小时阿片类药物摄入量。使用曲马多患者自控镇痛来管理术后疼痛。其他变量为人口统计学和手术相关参数。使用视觉模拟量表评估术后疼痛。使用 3dMD Face System(3dMD,美国)测量术后肿胀。使用两独立样本 t 检验和 Mann Whitney U 检验分析数据。

结果

研究样本由 30 名平均年龄为 20.63 岁的患者组成,其中 21 名为女性。与安慰剂组相比,预防性给予右酮洛芬可使术后曲马多消耗减少 25.9%,且 VAS 评分有统计学显著降低(p<0.05)。两组在肿胀方面无统计学显著差异(p>0.05)。

结论

预防性给予静脉右酮洛芬可在术后 24 小时内提供充分的镇痛效果,并减少正颌手术中的阿片类药物消耗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/216e/10181024/650b83f49d9d/medoral-28-e199-g001.jpg

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