Assari Ahmad Salem, Algharbi Elaf Mubarak Abdullah, Abuhabsha Abdulmajeed Mohammed, Alshammry Basel Basheer, Alanazi Yosef Aeed, Abuhaimed Reem Abdulaziz, Alzahrani Ali Mohammad Ali, Alduhaim Abdulrahaman Saud
Oral Maxillofacial Surgery Diagnostic Sciences Department, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Front Oral Health. 2024 Nov 18;5:1360298. doi: 10.3389/froh.2024.1360298. eCollection 2024.
This systematic review aimed to assess the effectiveness of submucosal tramadol injections in post-operative pain management following third molar surgical extraction.
Databases, such as PubMed, Scopus, ScienceDirect, and Cochrane Library, were systematically searched using relevant keywords. Randomized clinical trials that met the inclusion criteria were assessed to determine the effectiveness of tramadol in managing acute post-operative pain following third molar surgery.
In total, seven studies with participants of 18 and over following randomized placebo-controlled trials were considered for the analysis. A submucosal injection of 2 ml (50-100 mg) of tramadol adjacent to the impacted mandibular third molar effectively controlled pain for up to 6-24 h following surgery. Non-serious adverse events, such as nausea, vomiting, and headache, were reported in two studies. Meta-analysis (subgroup analysis) revealed heterogeneity among the studies, demonstrating variability in the results across the included studies. In addition, tramadol demonstrated a significant decrease in post-operative pain.
Submucosal tramadol is an efficient, safe, and dependable method for reducing post-operative acute pain, particularly in the first 6 h following impacted third molar surgery. However, due to the observed heterogeneity in the research, there is need for cautious interpretation of the findings and potential limitations in the evidence base. To enhance the quality of evidence on this topic, we strongly recommend conducting new RCTs using established methodologies.
Post operative pain following third molar surgeries is one of the common complications. Submucosal tramadol injections were found to be successful in reducing post extraction pain as well as other morbidities.
本系统评价旨在评估黏膜下注射曲马多在第三磨牙拔除术后疼痛管理中的有效性。
使用相关关键词对PubMed、Scopus、ScienceDirect和Cochrane图书馆等数据库进行系统检索。对符合纳入标准的随机临床试验进行评估，以确定曲马多在管理第三磨牙手术后急性疼痛方面的有效性。
总共纳入了7项针对18岁及以上参与者的随机安慰剂对照试验进行分析。在下颌阻生第三磨牙附近黏膜下注射2 ml（50 - 100 mg）曲马多可有效控制术后长达6 - 24小时的疼痛。两项研究报告了非严重不良事件，如恶心、呕吐和头痛。荟萃分析（亚组分析）显示研究之间存在异质性，表明纳入研究的结果存在差异。此外，曲马多在术后疼痛方面有显著减轻。
黏膜下注射曲马多是一种有效、安全且可靠的减轻术后急性疼痛的方法，尤其是在阻生第三磨牙手术后的前6小时。然而，由于研究中观察到的异质性，需要谨慎解释研究结果以及证据基础中的潜在局限性。为提高该主题的证据质量，我们强烈建议使用既定方法开展新的随机对照试验。
第三磨牙手术后的疼痛是常见并发症之一。发现黏膜下注射曲马多在减轻拔牙后疼痛以及其他发病率方面是成功的。
