Postoperative analgesia in dental day case surgery

Wakeling, H.; Barry, P. Creagh; Butler, Patrick J.

doi:10.1111/j.1365-2044.1996.tb07898.x

Cited by 10 publications

(2 citation statements)

References 3 publications

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“…Corticosteroids are employed particularly after surgery to limit the accumulation of inflammatory mediators and reduce fluid transudation and edema [ 3 13 16 ]. In this study, the mean values for postoperative swelling were significantly lower in the study group compared to control group, especially on the second day after surgery.…”

Section: Discussionmentioning

confidence: 99%

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The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

Latt

Kiattavorncharoen

Boonsiriseth

et al. 2016

J Dent Anesth Pain Med

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BackgroundSurgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery.MethodsA controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo.ResultsThe pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences.ConclusionsInjection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.

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Section: Discussionmentioning

confidence: 99%

“…The role of corticosteroids in preventing postoperative pain is controversial. Corticosteroids are employed particularly after surgery to limit the accumulation of inflammatory mediators and reduce fluid transudation and edema [ 3 13 16 ].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

Latt

Kiattavorncharoen

Boonsiriseth

et al. 2016

J Dent Anesth Pain Med

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Single dose oral piroxicam for acute postoperative pain

Moore¹,

Edwards

Loke

et al. 2000

Cochrane Database of Systematic Reviews

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Background This is an updated version of the original Cochrane review published in Issue 2, 2000. Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) with analgesic properties, and is used mainly for treating rheumatic disorders. Some drugs have been directly compared against each other within a trial setting to determine their relative efficacies, whereas other have not. It is possible, however, to compare analgesics indirectly by examining the effectiveness of each drug against placebo when used in similar clinical situations. Objectives To determine the analgesic efficacy and adverse effects of single-dose piroxicam compared with placebo in moderate to severe postoperative pain. To compare the effects of piroxicam with other analgesics. Search methods Published studies were identified from systematic searching of MEDLINE, Biological Abstracts, EMBASE, CENTRAL and the Oxford Pain Relief Database in December 2007. Additional studies were identified from the reference lists of retrieved reports. Selection criteria The following inclusion criteria were used: full journal publication, randomised placebo controlled trial, double-blind design, adult participants, postoperative pain of moderate to severe intensity at the baseline assessment, postoperative administration of oral or intramuscular piroxicam. Data collection and analysis Summed pain intensity and pain relief data were extracted and converted into dichotomous information to yield the number of participants obtaining at least 50% pain relief. This was used to calculate estimates of relative benefit and number-needed-to-treat-to-benefit (NNT) for one participant to obtain at least 50% pain relief. Information was collected on adverse effects and estimates of relative risk and number-needed-to-treat-to-harm (NNH) were calculated. Main results In this update no further studies were found. The original search identified three studies (141 participants) which compared oral piroxicam 20 mg with placebo and one (15 participants) compared oral piroxicam 40 mg with placebo. For single doses of piroxicam 20 mg and 40 mg the respective NNT for at least 50% pain relief were 2.7 (2.1 to 3.8) [95% confidence interval (CI)] and 1.9 (1.2 to 4.3) [95% CI] compared with placebo over four to six hours in moderate to severe postoperative pain. The reported incidence of adverse effects was no higher with piroxicam (20 mg or 40 mg) than with placebo. No further additional studies were found in the updated search. Authors’ conclusions Piroxicam appears to be of similar efficacy to other NSAIDs and intramuscular morphine 10 mg when used as a single oral dose in the treatment of moderate to severe postoperative pain.

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