Lages Lívio Portela de Deus, Bergamaschi Cristiane de Cássia, Lopes Luciane Cruz, da Frota Eduardo Gomes, Silva Marcus Tolentino, Monte Thiago Lima, Motta Rogério Heládio Lopes
PhD Program, Faculdade São Leopoldo Mandic, Campinas, Brazil.
Pharmaceutical Science Graduate Course, University of Sorocaba, Sorocaba, Brazil.
Front Pharmacol. 2024 Jul 15;15:1385401. doi: 10.3389/fphar.2024.1385401. eCollection 2024.
Periodontal procedures can promote prolonged intense pain, particularly in clinical situations requiring surgical procedures. In this context, preemptive analgesia has also been assessed for its utility in controlling post-operative pain and discomfort in patients undergoing periodontal invasive procedures. This study assessed the efficacy and safety of preemptive oral analgesia with steroidal and non-steroidal anti-inflammatory drugs in periodontal surgeries. This systematic review performed a search in the following electronic sources: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Virtual Health Library and in clinical trials electronic databases for relevant randomized clinical trials (RCTs); published up to July 2023. Primary outcomes assessed were post-operative pain, edema and trismus. A narrative synthesis of the findings was carried out. Six RCTs, involving a total of 250 participants, were included. The studies reviewed had a high risk of bias, particularly due to allocation concealment and blinding of participants and personnel. The RCTs reported only the outcome pain. The preemptive use of dexamethasone 8 mg, etoricoxib 90 mg or 120 mg and ketorolac 20 mg seems to be more effective for controlling post-operative pain than placebo. The anti-inflammatory drugs evaluated proved to be effective for controlling post-operative pain. However, given the limitations regarding lack of studies, methodological biases, disparities in drugs and doses, report restricted the pain outcome; further RCTs confirming the effectiveness and safety of these drugs in periodontal surgical procedures are warranted.
牙周手术可能会导致长时间的剧痛，尤其是在需要进行外科手术的临床情况下。在这种背景下，人们也评估了超前镇痛在控制接受牙周侵入性手术患者术后疼痛和不适方面的效用。本研究评估了甾体类和非甾体类抗炎药进行超前口服镇痛在牙周手术中的疗效和安全性。本系统评价在以下电子资源中进行了检索：Cochrane对照试验中央注册库（CENTRAL）、医学期刊数据库（通过PubMed）、荷兰医学文摘数据库（通过Ovid）、科学引文索引数据库、虚拟健康图书馆以及临床试验电子数据库，以查找相关的随机临床试验（RCT）；检索截至2023年7月发表的文献。评估的主要结局为术后疼痛、水肿和牙关紧闭。对研究结果进行了叙述性综合分析。纳入了6项RCT，共涉及250名参与者。所审查的研究存在较高的偏倚风险，尤其是在分配隐藏以及参与者和人员的盲法方面。这些RCT仅报告了疼痛结局。术前使用8毫克地塞米松、90毫克或120毫克依托考昔以及20毫克酮咯酸似乎比安慰剂在控制术后疼痛方面更有效。所评估的抗炎药被证明对控制术后疼痛有效。然而，鉴于研究数量不足、方法学偏倚、药物和剂量差异等局限性，报告仅限于疼痛结局；有必要开展进一步的RCT以证实这些药物在牙周手术中的有效性和安全性。
