Pre-emptive 8 mg dexamethasone and 120 mg etoricoxib for pain prevention after periodontal surgery: A randomised controlled clinical trial

Konuganti, Kranti; Rangaraj, Mani; Elizabeth, Anjana

doi:10.4103/0972-124x.153475

Cited by 10 publications

(34 citation statements)

References 16 publications

(19 reference statements)

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“…Through both databases, 149 scientific articles were identified. This revision did not include clinical trials using etoricoxib in endodontics or periodontics, as well as those studies comparing etoricoxib with an active control other than NSAIDs [33][34][35][36][37]. After excluding duplicate reports and considering the focus of this review, 11 papers fulfilled the PICO strategy (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis

Torre

Franco-González

Brennan-Bourdon

et al. 2021

Behavioural Neurology

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Background. The purpose of this meta-analysis was to assess the clinical efficacy of etoricoxib in comparison with traditional NSAIDs for postoperative pain after third molar surgery. Methods. The quality of studies found in PubMed and Google Scholar was evaluated with Cochrane Collaboration’s risk of bias tool. Data on total consumption of rescue analgesics, number of patients using rescue analgesics, global assessment of study treatments, and adverse effects were extracted exclusively from high-quality clinical trials. Each meta-analysis was performed with the Review Manager Software 5.3 for Windows. Results. The qualitative analysis showed that etoricoxib has better analgesic activity when compared with ibuprofen (2 clinical trials) and diclofenac (1 clinical trial). A similar analgesic efficacy between etoricoxib and nonselective Cox-2 NSAIDs was informed in 3/8 studies (2 compared to ibuprofen and 1 to naproxen sodium). Moreover, the number of patients requiring rescue analgesics in the postoperative period showed a statistical difference in favor of etoricoxib when compared to NSAIDs. Conclusion. Etoricoxib significantly reduces the number of patients needing rescue analgesics compared to NSAIDs after third molar surgery.

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Section: Resultsmentioning

confidence: 99%

Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis

Torre

Franco-González

Brennan-Bourdon

et al. 2021

Behavioural Neurology

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“…Nonetheless, no studies evaluating the preemptive effects of nimesulide in periodontal surgeries were found. Studies on preemptive analgesia in periodontal surgeries have used different steroidal and non‐steroidal drugs, such as dexamethasone, eterocoxib, and celocoxib 15,27,37,38 . Overall, results showed beneficial effects of preemptive analgesia on pain control and on the quantity of rescue medication when compared to the use of placebo.…”

Section: Discussionmentioning

confidence: 99%

Preemptive effects of ibuprofen and nimesulide on postoperative pain control after open flap periodontal surgeries: A randomized placebo‐controlled split‐mouth clinical trial

Santos

Costa

Vasconcelos

et al. 2021

Journal of Periodontology

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Background Data on preemptive analgesia in periodontal surgeries are scarce and still diverse. The aim of this study was to evaluate and compare the analgesic effects of the preemptive administration of ibuprofen and nimesulide in open flap periodontal surgeries. Methods The present randomized controlled clinical trial comprised 40 individuals, divided into two groups (n = 20), according to the test drug (ibuprofen and nimesulide) to be administered 1 hour preoperatively. Participants underwent bilateral periodontal surgeries at two different times, and were randomly given the test drug or placebo in a split‐mouth design. Postoperative pain and rescue medication were evaluated at different times. Comparisons between ibuprofen and nimesulide were performed through a Generalized Estimation Equation model, using test drug and evaluation times, along with an interaction between these two variables as predictors. Results In intergroup comparisons regarding pain control, ibuprofen showed better effects than placebo only at the first postoperative hour, whereas nimesulide showed better effects than placebo at 1, 6, 24, and 48 postoperative hours. In intergroup comparisons, nimesulide showed better effects than ibuprofen at 24, 48, and 72 postoperative hours, demonstrating a higher overall preemptive effect. No differences were observed in relation to the number of rescue medication. Conclusion Preemptive administration of nimesulide showed better overall preemptive effects on postoperative pain control when compared with ibuprofen.

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“…In two studies, patients who needed to take backup medication were excluded from the analysis [18,30]. In most cases, patients who needed backup medication were part of placebo group [15,19,23,25,26,[31][32][33].…”

Section: Studies Characteristicsmentioning

confidence: 99%

“…The methodological quality of each study was classified as low, high, or some concerns. A substantial risk of bias was determined for 9 studies [14,15,17,20,29,31,[38][39][40], some concerns for one study [28], and a low risk of bias for the others.…”

Section: Risk Of Biasmentioning

confidence: 99%

Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis

et al. 2020

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Objectives To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. Materials and methods Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. Results Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. Conclusions Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. Clinical relevance There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.

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Pre-emptive 8 mg dexamethasone and 120 mg etoricoxib for pain prevention after periodontal surgery: A randomised controlled clinical trial

Cited by 10 publications

References 16 publications

Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis

Analgesic Efficacy of Etoricoxib following Third Molar Surgery: A Meta-analysis

Preemptive effects of ibuprofen and nimesulide on postoperative pain control after open flap periodontal surgeries: A randomized placebo‐controlled split‐mouth clinical trial

Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis

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