Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction

Trindade, Paulo Alceu Kiemle; Giglio, Fernando Paganeli Machado; Ishikiriama, Bella Luna Colombini; Calvo, Adriana Maria; Modena, Karin C. S.; Ribeiro, Debora A.; Dionísio, Thiago José; Brozoski, Daniel; Lauris, José Roberto Pereira; Faria, Flávio Augusto Cardoso de

doi:10.1016/j.ijom.2010.10.026

Cited by 22 publications

(27 citation statements)

References 31 publications

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“…That is, a single 20 mg dose of piroxicam can be taken orally only once a day to effectively manage pain, inflammation and swelling resulting from third molar extraction. 4,5,6 Moreover, piroxicam is metabolized by CYP2C9, a cytochrome P450 enzyme, creating 5'-hydroxypiroxicam by hydrolysis. This study's objective was to evaluate different concentrations of piroxicam and its major metabolite, 5'-hydroxypiroxicam, in human plasma samples over time using HPLC after liquid-liquid extraction.…”

Section: Discussionmentioning

confidence: 99%

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Effective method for the detection of piroxicam in human plasma using HPLC

et al. 2016

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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used by the general population to alleviate inflammation and pain after oral surgeries. Piroxicam is among the most commonly used NSAIDs and excels in controlling pain, swelling, trismus and other common symptoms of inflammation. This study aimed to evaluate different concentrations of piroxicam and its major metabolite, 5'-hydroxypiroxicam, in human plasma samples over time using high performance liquid chromatography (HPLC) after liquid-liquid extraction. Briefly, 10 volunteers participated in this study after approval by the Ethics Committee of Bauru School of Dentistry, Universidade de São Paulo -USP, Brazil. Volunteers received a single dose oral of piroxicam (20 mg) and had blood collected at various times following an established protocol. The methodology of liquid-liquid extraction was effective for determining concentrations of piroxicam in plasma using HPLC in 10 out of 10 volunteers while 5'-hydroxypiroxicam was only detected in 2 out of 10 volunteers.

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Section: Discussionmentioning

confidence: 99%

“…1,2,3 Piroxicam, in particular, is a commonly used NSAID which inhibits prostaglandin production, often employed to manage pain, swelling and trismus after oral surgeries. 4,5,6 Cytochrome P4502C9 (CYP2C9) is the main enzyme involved with metabolizing piroxicam to 5'-hydroxypiroxicam. Moreover, urinary excretion of unmetabolized piroxicam is rare.…”

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confidence: 99%

Effective method for the detection of piroxicam in human plasma using HPLC

et al. 2016

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“…This route avoids the first-pass metabolism in the liver and also the drug gets absorbed by the veins in the floor of the mouth, leading directly to superior vena cava, leading to the faster distribution of the drug. 10 However, conflicting to our view, Trindade et al 11 compared the oral vs sublingual piroxicam in the postoperative pain management after lower third molar extraction and found no significant difference in between the two routes of drug administration in terms of pain management.…”

Section: Discussionmentioning

confidence: 78%

Sublingual Piroxicam as Preemptive Analgesia in Single Implant Surgery

Bhutani¹,

Sangolikar²,

Bhutani³

et al. 2019

The Journal of Contemporary Dental Practice

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Aim:The aim of this study is to evaluate the efficacy of sublingual piroxicam as a preemptive analgesic agent in patients undergoing single implant surgery. Materials and methods: This was a prospective triple-blind placebo-controlled trial that involved 40 patients presented for the placement of a single endosteal implant in the posterior maxillary arch. Patients were randomly allocated to one of the following groups. Group I (study) who received sublingual piroxicam 40 mg 1 hour prior to the surgical procedure and group II (control) received placebo 1 hour before the surgery, both the groups received sublingual piroxicam 20 mg tablet twice a day on the first and the second postoperative day and once a day on the postoperative day 3. Visual analog scores for measuring pain intensity were assessed at postoperative 1 hour, 6 hours, days 1, 3, and 5. Facial swelling was measured and evaluated during the first, third, and fifth postoperative days using the digital vernier caliper. The Mann-Whitney U test was used to make between-group comparisons. The Wilcoxon-signed rank test was used to make within-group comparisons. Results: At all-time intervals, both mean pain and mean swelling scores were higher in controls as compared with those of cases. The difference between the two groups was also statistically significant at all-time intervals for both parameters except for pain at 1 hour. Conclusion: Our findings suggest that preoperative sublingual piroxicam is more effective for controlling postoperative pain and swelling after surgical implant placement than only postoperative administration.

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“…It has antipyretic, analgesic and anti‐inflammatory properties and the ability to reduce pain from different arthritic conditions and treat post‐operative inflammation . Similarly, the administration of PRX to patients subjected to laparoscopic surgery reduced post‐operative pain …”

Section: Introductionmentioning

confidence: 99%

Simultaneous determination of piroxicam and norfloxacin in biological fluids by high‐performance liquid chromatography with fluorescence detection at zero‐order emission mode

et al. 2019

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A new highly sensitive high-performance liquid chromatographic method with fluorescence detection (HPLC-FLD) in zero-order emission mode was developed for the first time for the simultaneous determination of piroxicam (PRX) and norfloxacin (NRF) in biological fluids. The fluorescence detector wavelengths were set at 278 nm for excitation and zero-order mode for emission. The zero-order emission mode produced greater sensitivity for the measurement of both drugs than a fixed emission wavelength (446 nm). The new developed method was validated according to International Conference of Harmonization (ICH) guidelines. Linearity was found to be over concentration ranges 0.001-20 μg/ml and 0.00003-0.035 μg/ml for PRX and NRF, respectively. The limits of detection were 4.87 × 10 −4 and 1.32 × 10 −5 μg/ml for PRX and NRF, and the limits of quantitation were 1.47 × 10 −3 and 4.01 × 10 −5 μg/ml, respectively. The current fluorescence method was found to be more sensitive than most commonly used analytical methods and was successfully applied for simultaneous determination of PRX and NRF in biological fluids (serum and urine) with recoveries ranging from 91.67% to 100.36% for PRX and from 96.00% to 101.43% for NRF.

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Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction

Cited by 22 publications

References 31 publications

Effective method for the detection of piroxicam in human plasma using HPLC

Effective method for the detection of piroxicam in human plasma using HPLC

Sublingual Piroxicam as Preemptive Analgesia in Single Implant Surgery

Simultaneous determination of piroxicam and norfloxacin in biological fluids by high‐performance liquid chromatography with fluorescence detection at zero‐order emission mode

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