Sharma Roohika, George Melvin, Krishnan Murugesan
Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Apr 14;16(4):e58262. doi: 10.7759/cureus.58262. eCollection 2024 Apr.
Background and objective This study aims to explore the concept of preemptive analgesia, which is the technique of administration of analgesic agents before the painful stimulus. This bridges the time gap between the onset of action of the analgesic agents and the wear-off of local anesthesia. Existing literature also brings up the concept of central sensitization, which is the hyper-activity of the nervous system in response to a noxious stimulus. Administration of preemptive analgesia prevents central sensitization and hence provides prolonged analgesia to the patient. For the benefit of this study, tab. Etoricoxib 90 mg was used as the analgesic agent. In addition, this study aims to investigate the effects of the administration of tab. Etoricoxib 90 mg 30 minutes before extraction of a single mandibular third molar on the effects of pain experienced by the patient after tooth extraction as compared to a placebo. Methodology This was a double-blinded, prospective, observational study. The pain experienced by 50 participants in each group was measured at 1 hour, 6 hours, 12 hours, and 24 hours postoperatively using a visual analog scale (VAS). The independent samples t-test was then conducted to evaluate the results and draw out conclusions. Results The average difference in pain experienced was maximum in the first hour after the procedure. The mean VAS score reported by patients was 3.14 in the study group but was 6.40 in the control group within the first hour. This difference was reduced in the first six hours after the procedure, with the average score being 3.82 in the study and 7.16 in the control group. The difference was the least after 12 hours, with the study group experiencing a VAS score of 4.64 and controls experiencing a VAS score of 6.14. After the first 24 hours, the mean VAS score was 3.80 in the study group and 5.60 in the control group. Conclusions Preemptive administration of tab. Etoricoxib 90 mg can reduce postextraction pain in healthy adult patients as compared to placebo tablets, with a maximum difference in pain reduction seen at the end of the first six hours (= 0.012) and the minimum at the end of 12 hours (= 0.0197).
背景与目的 本研究旨在探讨超前镇痛的概念,即于疼痛刺激前给予镇痛药物的技术。这填补了镇痛药物起效与局部麻醉消退之间的时间间隔。现有文献还提出了中枢敏化的概念,即神经系统对有害刺激的过度反应。给予超前镇痛可预防中枢敏化,从而为患者提供持久的镇痛效果。为便于本研究,选用90毫克依托考昔片作为镇痛药物。此外,本研究旨在调查在拔除单颗下颌第三磨牙前30分钟服用90毫克依托考昔片与服用安慰剂相比,对患者拔牙后疼痛感受的影响。方法 这是一项双盲、前瞻性观察研究。术后1小时、6小时、12小时和24小时,使用视觉模拟量表(VAS)测量每组50名参与者的疼痛感受。然后进行独立样本t检验以评估结果并得出结论。结果 术后第1小时,疼痛感受的平均差异最大。在第1小时内,研究组患者报告的平均VAS评分为3.14,而对照组为6.40。术后前6小时,这种差异减小,研究组平均评分为3.82,对照组为7.16。12小时后差异最小,研究组VAS评分为4.64,对照组为6.14。术后24小时后,研究组平均VAS评分为3.80,对照组为5.60。结论 与安慰剂片相比,术前给予90毫克依托考昔片可减轻健康成年患者拔牙后的疼痛,在术后前6小时末疼痛减轻差异最大(P = 0.012),12小时末差异最小(P = 0.0197)。