Preoperative analgesics for additional pain relief in children and adolescents having dental treatment

Ashley, Paul; Parekh, Susan; Moles, David R; Anand, Prabhleen; Behbehani, Amal

doi:10.1002/14651858.cd008392

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…In all reviews, the reporting of 8 of the 11 items was adequate (Figure 1 ). The weakest area was failure to report the likelihood of publication bias, in 14 reviews (38%), which did not assess publication bias [ 11 - 13 , 17 , 19 , 20 , 24 - 26 , 34 , 35 , 38 , 42 , 43 ]. One review did not use “grey” literature as an inclusion criterion [ 34 ] and in another, the methods used to combine the findings of studies were inappropriate [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

2014

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BackgroundTo ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice.MethodsWe conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence).ResultsWe selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars.ConclusionsCochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence.

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Section: Resultsmentioning

confidence: 99%

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

2014

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“…We identified 3570 potentially relevant publications, of which 36 systematic reviews 15‐50 were ultimately included in our analysis (Box 1; , table 3). Of 112 publications deemed potentially eligible by abstract review, 76 were excluded after reviewing the full text (Box 1; , table 4); the conclusions of excluded reviews that covered the same topic as reviews included in our overview are summarised in , table 5.…”

Section: Resultsmentioning

confidence: 99%

“…Evidence that paracetamol is not superior to placebo for relieving the pain of sore throat in people with common colds, 20 migraine in children and adolescents, 27 pain during hysterosalpingography, 24 pain in newborns, 50 dental surgery in children, 25 uterine cramping/involution after birth, 15 or reconstructive vaginal surgery 46 is of low quality (Box 3, Box 4).…”

Section: Resultsmentioning

confidence: 99%

The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews

Shaheed

Ferreira

Dmitritchenko

et al. 2021

Medical Journal of Australia

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Objective To evaluate the efficacy and safety of paracetamol as an analgesic medication in a range of painful conditions. Study design Systematic review of systematic reviews of the analgesic effects of paracetamol in randomised, placebo‐controlled trials. Conduct of systematic reviews was assessed with AMSTAR‐2; confidence in effect estimates (quality of evidence) was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data sources MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews; systematic reviews published 1 January 2010 – 30 April 2020. Data synthesis We extracted pain and adverse events outcomes from 36 systematic reviews that assessed the efficacy of paracetamol in 44 painful conditions. Continuous pain outcomes were expressed as mean differences (MDs; standardised 0–10‐point scale); dichotomous outcomes were expressed as risk ratios (RRs). There is high quality evidence that paracetamol provides modest pain relief for people with knee or hip osteoarthritis (MD, –0.3 points; 95% CI, –0.6 to –0.1 points) and after craniotomy (MD, –0.8 points; 95% CI, –1.4 to –0.2 points); there is moderate quality evidence for its efficacy in tension‐type headache (pain‐free at 2 hours: RR, 1.3; 95% CI, 1.1–1.4) and perineal pain soon after childbirth (patients experiencing 50% pain relief: RR, 2.4; 95% CI, 1.5–3.8). There is high quality evidence that paracetamol is not effective for relieving acute low back pain (MD, 0.2 points; 95% CI, –0.1 to 0.4 points). Evidence regarding efficacy in other conditions was of low or very low quality. Frequency of adverse events was generally similar for people receiving placebo or paracetamol, except that transient elevation of blood liver enzyme levels was more frequent during repeated administration of paracetamol to patients with spinal pain (RR, 3.8; 95% CI, 1.9–7.4). Conclusions For most conditions, evidence regarding the effectiveness of paracetamol is insufficient for drawing firm conclusions. Evidence for its efficacy in four conditions was moderate to strong, and there is strong evidence that paracetamol is not effective for reducing acute low back pain. Investigations that evaluate more typical dosing regimens are required. PROSPERO registration CRD42015029282 (prospective).

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“…Besides that, possible confounding factors were addressed and controlled by adjusted multiple linear regression and, to the best of our knowledge, this is the first study on this thematic that performed this type of analysis, highlighting the importance of our findings. All the issues discussed on the Cochrane Systematic Review 15 about the low methodological quality of available studies about this thematic were addressed in this study such as sample size calculation, record baseline anxiety, and select well‐defined age ranges with appropriate outcome measures. However, new studies evaluating the pre‐emptive effect of analgesics or even other medications (eg corticosteroids) in primary teeth extractions are needed in different populations in order to better elucidate this clinical controversy.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review stated that the available evidence is not sufficient to determine whether pre‐emptive administration of analgesics is beneficial in terms of reducing post‐operative pain in the paediatric population. It is evidenced the low methodological quality of the studies available in the literature, mainly regarding the representativeness of the samples and the use of appropriate instruments for the measurement of the pain 15 …”

Section: Introductionmentioning

confidence: 99%

Does the pre‐emptive administration of paracetamol or ibuprofen reduce trans‐ and post‐operative pain in primary molar extraction? A randomized placebo‐controlled clinical trial

Santos

Massignan

Oliveira

et al. 2020

Int J Paed Dentistry

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Background: There is no consensus whether the pre-emptive administration of analgesics reduces trans-and post-operative pain in primary molar extraction. Aim: Investigate whether the pre-emptive administration of ibuprofen and paracetamol reduces trans-and post-operative pain on primary molars extraction compared to placebo. Design: A parallel, placebo-controlled, triple-blind, randomized clinical trial was conducted. Forty-eight children who needed primary molar tooth extraction were selected and treated under local anaesthesia and pre-emptive administration of placebo or analgesics. Self-reported pain was evaluated during the anaesthesia, extraction, and 2, 6, and 24 hours of post-operative period, using a visual analogue scale (VAS). Children's baseline anxiety, behaviour during the procedure, parents' anxiety, and post-operative analgesia were also assessed. Data analysis included descriptive statistics and multiple linear regression. Results: No association was found between the use of pre-emptive analgesic and lower scores of trans-and post-operative pain compared to placebo. Children who presented negative behaviour reported greater pain during anaesthesia (P = .04) regardless of pre-emptive analgesia group. Children from the placebo group were more likely to need post-operative analgesia at 2 hours of follow-up (P = .03). Conclusion: The pre-emptive administration of analgesics did not significantly reduce trans-and post-operative pain in children after primary molars extraction.

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Preoperative analgesics for additional pain relief in children and adolescents having dental treatment

Cited by 7 publications

References 11 publications

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews

Does the pre‐emptive administration of paracetamol or ibuprofen reduce trans‐ and post‐operative pain in primary molar extraction? A randomized placebo‐controlled clinical trial

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