Oral pregabalin for postoperative pain relief after third molar extraction: a randomized controlled clinical trial

Olmedo-Gaya, María Victoria; Manzano-Moreno, Francisco Javier; Gálvez-Mateos, R.; González-Rodrı́guez, Marı́a Paloma; Talero-Sevilla, Cristina; Vallecillo-Capilla, Manuel

doi:10.1007/s00784-015-1657-3

Cited by 15 publications

(23 citation statements)

References 38 publications

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“…Of note, although pregabalin does not have anti‐inflammatory activity, there is evidence that it attenuates acute postoperative pain , which is consistent with its MoA in affecting neuronal transmission in the pain processing pathways, and also the findings obtained in UVB‐irradiated skin in the present study. Finally, in line with the proven clinical effects of pregabalin and other anti‐epileptic drugs, such as gabapentin and carbamazepine , pregabalin induced a consistent antinociceptive effect on objective and subjective readouts, following (laser) heat stimulation on capsaicin‐irritated skin, which has been hypothesized to resemble neuropathic pain symptoms .…”

Section: Discussionmentioning

confidence: 79%

Investigation of the predictive validity of laser‐EPs in normal, UVB‐inflamed and capsaicin‐irritated skin with four analgesic compounds in healthy volunteers

Schaffler¹,

Nicolas

Borta

et al. 2017

Brit J Clinical Pharma

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Section: Discussionmentioning

confidence: 79%

Investigation of the predictive validity of laser‐EPs in normal, UVB‐inflamed and capsaicin‐irritated skin with four analgesic compounds in healthy volunteers

Schaffler¹,

Nicolas

Borta

et al. 2017

Brit J Clinical Pharma

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“…Ineffectiveness of gabapentinoids (i.e. non-indications) is suggested for preemptive and postoperative analgesia [14,15] or radiation-induced mucositis analgesia [43]. A Cochrane review on the analgesic effect of gabapentin in 2010 concluded that although such an effect does exist (when compared to placebo) it is not clinically significant (as compared to standard analgesics) [49].…”

Section: Discussionmentioning

confidence: 99%

“…Four RCTs of good methodological quality (61.5 to 79/100) assessed the usefulness of pregabalin in preemptive analgesia and/or postoperative analgesia before or following third molar surgery [13][14][15] or orthognathic surgery [16]. One double-blind RCT showed that a single postoperative 300 mg dose of pregabalin was superior to ibuprofen or placebo for pain relief following third molar surgery [13].…”

Section: Postoperative Painmentioning

confidence: 99%

“…One double-blind RCT showed that a single postoperative 300 mg dose of pregabalin was superior to ibuprofen or placebo for pain relief following third molar surgery [13]. Two other RCTs did not show any significant effect of 75 mg pregabalin 1 hour prior and/or after third molar surgery [14,15]. Finally, one double-blind RCT on 40 patients showed that 75 mg pregabalin 1 hour prior to general anesthesia induction allowed a significant decrease in pain and postoperative opioid consumption following orthognathic surgery [16].…”

Section: Postoperative Painmentioning

confidence: 99%

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Gabapentinoid prescription in Oral Medicine and Oral Surgery practice. Part II − a systematic scoping review of the literature

Sulukdjian

L'Homme

Chanlon

et al. 2020

J Oral Med Oral Surg

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Introduction: Gabapentinoids, pregabalin and gabapentin, neuronal voltage-gated calcium channel inhibitors are first-line treatments for painful neuropathic conditions (and several non-neuropathic painful conditions). Nevertheless, their efficacy and prescription in Oral Medicine and Oral Surgery practice has received little attention so far. A previous article, the first of a two-part series, presented the experience of a French tertiary orofacial pain clinic regarding the prescription of gabapentinoids in orofacial conditions. This second article aimed to explore the scientific literature on the subject. Material and methods: A systematic scoping review was conducted on multiple relevant databases (MEDLINE®, Cochrane®, Agence Nationale de Sécurité du Médicament et des produits de santé, Haute Autorité de Santé) and journal archives (JOMOS, JSOMFS) to assess the indications, non-indications and contraindications of gabapentinoids in an Oral Medicine/Oral Surgery context. Results: Out of 131 records selected during the initial screening, 34 matched the inclusion criteria and were used for subsequent analyses. Gabapentinoids were prescribed in three clinical contexts: orofacial pain management (32 studies), anxiolysis (1 study) and prevention of postoperative nausea/vomiting (1 study), with variable quality of evidence: high (6 studies), moderate (3 studies), low (5 studies) and very low (20 studies) quality studies (GRADE scale). Untoward effects of gabapentinoids were reported in 16 studies, mainly neurological (vertigo, drowsiness, sedation) and gastro-intestinal (nausea, vomiting, diarrhea, constipation). Gabapentinoids were ineffective in preemptive and postoperative analgesia and for the management of mucositis-related pain. Discussion: There is some evidence supporting the use of gabapentinoids in Oral Medicine/Oral Surgery in adherence with current practices observed in France and other countries (practices often extrapolated from their use in other non-orofacial painful conditions). The methodological quality of the studies included in this scoping review is often poor and publication bias is most probable in this field. Therefore, any conclusion drawn from such studies must be subject to circumspection. Conclusion: Data obtained from the present scoping review suggests the potential use of gabapentinoids as second-line treatments for anxiolysis, prevention of postoperative nausea/vomiting and the management of trigeminal neuralgia and masticatory myalgia. Other potential indications of gabapentinoids in Oral Medicine/Oral Surgery practice include cranial neuralgias, post-traumatic trigeminal neuropathies, first bite syndrome, burning mouth syndrome and migraine prophylaxis, when other treatment options are inefficient or unavailable.

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“…Subsequently, the duration of the general symptoms varies from these first few hours to 10–15 days later. As a rule, this pain is controlled with oral analgesics, but long-lasting anaesthetics may also be used [ 8 ]. With the mouth, the most commonly used anaesthetic is articaine because of its ideal characteristics: fast onset, potency, and intermediate duration [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study between the Combination of Dexamethasone and Bupivacaine for Third Molar Surgery Postoperative Pain: A Triple-Blind, Randomized Clinical Trial

Quesada-Bravo

García-Carricondo

Espín-Gálvez

et al. 2021

JCM

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Objectives: To compare the possible benefits of the combination of dexamethasone–bupivacaine with articaine–epinephrine as an anaesthetic block after third molar surgery. Materials and Methods: Triple-blind, randomized, controlled, parallel, phase 3 clinical trial. Two groups: experimental (93 patients) with standard anaesthetic block: 40/0.005 mg/mL articaine–epinephrine and submucosal reinforcement with 0.8 mg dexamethasone–5% bupivacaine; and control group (91 patients) with standard block: 40/0.005 mg/mL articaine–epinephrine. The surgery consisted of the extraction of the impacted mandibular third molar by performing a procedure following the same repeatable scheme. The visual analogue scale (VAS) was used to analyse postoperative pain. Results: Groups were homogeneous, without significant differences related to epidemiological variables. Postoperative pain among the first, second, and seventh postoperative days was statistically significantly lower in the experimental group compared to the control group (p < 0.001). Drug consumption was lower in the experimental group throughout the study period (p < 0.04). Conclusion: Bupivacaine is an alternative to articaine in oral surgery, being more effective in reducing postoperative pain by reducing patients’ scores on the VAS as well as their consumption of analgesic drugs after surgery.

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Oral pregabalin for postoperative pain relief after third molar extraction: a randomized controlled clinical trial

Abstract: These findings suggest that pregabalin may be useful to control acute postoperative pain. Adverse effects are known to be reduced at the low pregabalin dose used in our study.

Cited by 15 publications

References 38 publications

Investigation of the predictive validity of laser‐EPs in normal, UVB‐inflamed and capsaicin‐irritated skin with four analgesic compounds in healthy volunteers

Investigation of the predictive validity of laser‐EPs in normal, UVB‐inflamed and capsaicin‐irritated skin with four analgesic compounds in healthy volunteers

Gabapentinoid prescription in Oral Medicine and Oral Surgery practice. Part II − a systematic scoping review of the literature

Comparative Study between the Combination of Dexamethasone and Bupivacaine for Third Molar Surgery Postoperative Pain: A Triple-Blind, Randomized Clinical Trial

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