Pain and analgesic response after third molar extraction and other postsurgical pain

Barden, Jodie; Edwards, Jayne E; McQuay, Henry J; Moore, R Andrew

doi:10.1016/j.pain.2003.09.021

Cited by 145 publications

(88 citation statements)

References 17 publications

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“…Moreover, systematic reviews of these studies 20,21 support the clinical recommendation that NSAIDs should be the analgesics of first choice in patients who can tolerate this class of drugs. 2 Many NSAIDs -including ibuprofen, 18,22,23,[30][31][32] aspirin, 33,34 26 -have been shown to produce significant reductions in dental pain using randomized, double-blind placebo- controlled clinical trials. However, for purposes of this review, ibuprofen will be selected as a commonly used standard for NSAID treatment of acute dental pain.…”

Section: Trials/efficacymentioning

confidence: 99%

Drugs for pain management in dentistry

Hargreaves

Abbott

2005

Australian Dental Journal

101

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Pain is one of the most common reasons patients seek dental treatment. It may be due to many different diseases/conditions or it may occur after treatment. Dentists must be able to diagnose the source of pain and have strategies for its management. The '3-D's' principle -diagnosis, dental treatment and drugs -should be used to manage pain. The first, and most important, step is to diagnose the condition causing the pain and identify what caused that condition. Appropriate dental treatment should then be undertaken to remove the cause of the condition as this usually provides rapid resolution of the symptoms. Drugs should only be used as an adjunct to the dental treatment. Most painful problems that require analgesics will be due to inflammation. Pain management drugs include non-narcotic analgesics (e.g., non-steroidal anti-inflammatory drugs, paracetamol, etc) or opioids (i.e., narcotics). Nonsteroidal anti-inflammatory drugs (NSAIDs) provide excellent pain relief due to their anti-inflammatory and analgesic action. The most common NSAIDs are aspirin and ibuprofen. Paracetamol gives very effective analgesia but has little anti-inflammatory action. The opioids are powerful analgesics but have significant side effects and therefore they should be reserved for severe pain only. The most commonlyused opioid is codeine, usually in combination with paracetamol. Corticosteroids can also be used for managing inflammation but their use in dentistry is limited to a few very specific situations.Key words: Dentistry, pain, analgesics, non-steroidal antiinflammatory drugs, NSAIDs.Abbreviations and acronyms: ACTH = adrenocorticotrophic hormone; CNS = central nervous system; NSAIDs = non-steroidal anti-inflammatory drugs.Aust Dent J 2005;50 Suppl 2:S14-S22

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Section: Trials/efficacymentioning

confidence: 99%

Drugs for pain management in dentistry

Hargreaves

Abbott

2005

Australian Dental Journal

101

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“…The reason is that third molar extraction is a common procedure accompanied frequently by pain of moderate or severe intensity, and involves sufficient numbers of patients to make studies relatively easy to perform (1). The pain and swelling resulting from the surgery are generally caused by different factors, such as surgical trauma or endotoxins, which are treated with various therapeutic agents, including nonsteroidal anti-inflammatory drugs (NSAIDs, e.g., piroxicam, diclofenac, celecoxib), antibiotics, and others (2).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery

Barroso¹,

Lima²,

Guzzo³

et al. 2006

Braz J Med Biol Res

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Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin ® ) when compared with 20 mg piroxicam alone (Feldene ® ) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/ benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

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“…Third molar extraction is the most common model of postoperative pain used, and is acknowledged to provide good sensitivity with low placebo response (Barden 2004b). Random play of chance where numbers of participants are limited cannot be excluded as a cause of a negative result (Moore 1998).…”

Section: Discussionmentioning

confidence: 99%

Single dose oral aceclofenac for postoperative pain in adults

Moore¹,

Derry²,

McQuay³

2009

Cochrane Database of Systematic Reviews

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Background-Aceclofenac is the prodrug of the non-steroidal anti-inflammatory drug (NSAID) diclofenac, widely used to treat acute and chronic pain. There are no known systematic reviews of its analgesic efficacy in acute postoperative pain. This review sought to evaluate the efficacy and safety of oral aceclofenac in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.

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Pain and analgesic response after third molar extraction and other postsurgical pain

Cited by 145 publications

References 17 publications

Drugs for pain management in dentistry

Drugs for pain management in dentistry

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery

Single dose oral aceclofenac for postoperative pain in adults

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