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芬太尼透皮贴剂在下颌阻生第三磨牙手术中的疗效——一项对比研究

Efficacy of Fentanyl Transdermal Patch in Impacted Mandibular Third Molar Surgery-A Comparative Study.

作者信息

Thakur Deepak, Ravupalli Shashikant, Rao Sruthi, Ukey Viplove, Pandit Manish, Aftab Aafreen

机构信息

Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India.

V Y Institute of Medical Sciences, VY Hospital, Raipur, India.

出版信息

J Maxillofac Oral Surg. 2023 Sep;22(3):609-613. doi: 10.1007/s12663-022-01820-4. Epub 2022 Dec 2.

Abstract

INTRODUCTION

Removal of mandibular third molars surgically is one of the most frequently performed oral surgical procedures which are often accompanied with post-operative pain, swelling and trismus. Despite general progress in pain management, moderate to severe acute post-operative pain after removal of lower third molars remains a problem. Fentanyl is an extremely effective drug in the treatment of severe chronic pain such as cancer pain and post-operative pains which acts by increasing patient's tolerance to pain. Fentanyl Transdermal System (FTS) is a rectangular transdermal patch which contains high concentration of fentanyl, a potent short-acting Schedule II opiate. In this study the efficacy of transdermal fentanyl for management of post-operative pain after impacted mandibular 3rd molar surgery is evaluated.

METHODS

20 patients within the age group of 18-40 years with asymptomatic impacted mandibular third molars were equally divided into 2 groups as group A & group B which underwent surgery in Local Anaesthesia. In every patient one side belonged to group A and other side belonged to group B. 50 μg FTS was applied in group A while placebo patch was applied in group B.

RESULTS

Patients in group A performed significantly better than group B in terms of mean pain intensity scores assessed by VAS and VRS along with minimum need of post-operative rescue analgesics.

CONCLUSION

It was found that FTS resulted in significantly better pain relief, longer pain-free intervals, and lesser post-operative analgesic consumption.

摘要

引言

手术拔除下颌第三磨牙是最常进行的口腔外科手术之一,术后常伴有疼痛、肿胀和牙关紧闭。尽管在疼痛管理方面取得了总体进展,但拔除下颌第三磨牙后的中度至重度急性术后疼痛仍然是一个问题。芬太尼是治疗严重慢性疼痛(如癌症疼痛和术后疼痛)的极其有效的药物,它通过提高患者对疼痛的耐受性来发挥作用。芬太尼透皮系统(FTS)是一种长方形的透皮贴剂,含有高浓度的芬太尼,一种强效短效的II类阿片制剂。在本研究中,评估了透皮芬太尼对下颌阻生第三磨牙手术后疼痛管理的疗效。

方法

将20例年龄在18 - 40岁、无症状的下颌阻生第三磨牙患者平均分为A组和B组,两组均在局部麻醉下进行手术。每位患者一侧属于A组,另一侧属于B组。A组应用50μg的芬太尼透皮贴剂,B组应用安慰剂贴剂。

结果

在通过视觉模拟评分法(VAS)和视觉疼痛评分法(VRS)评估的平均疼痛强度评分以及术后急救镇痛药的最低需求量方面,A组患者的表现明显优于B组。

结论

研究发现,芬太尼透皮系统能显著更好地缓解疼痛,延长无痛间隔时间,并减少术后镇痛药的用量。

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引用本文的文献

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Comment to: "Efficacy of Fentanyl Transdermal Patch in Impacted Mandibular Third Molar Surgery-A Comparative Study".
J Maxillofac Oral Surg. 2025 Apr;24(2):594-595. doi: 10.1007/s12663-023-01899-3. Epub 2023 Mar 15.
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J Maxillofac Oral Surg. 2023 Jun;22(2):371-372. doi: 10.1007/s12663-023-01851-5. Epub 2023 Jan 12.

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