Efficacy and safety of parenteral and local application of tramadol in mandibular third molar extraction: a qualitative systematic review of current evidence.
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引用次数: 0
Abstract
Purpose: To assess the efficacy and safety of perioperative parenteral administration or submucosal infiltration of tramadol for perioperative pain control on the basis of pain intensity or analgesics consumption and perioperative outcomes in mandibular third molar surgery.
Material-methods: An electronic database search was conducted up to 10 November 2022 to retrieve all randomized controlled trials (RCTs), assessing the analgesic efficacy of parenteral use of tramadol implemented as an adjunct to local anesthesia or intraoperative sedation/general anesthesia, in surgical extraction of mandibular third molars. Modified Jadad scale and Cochrane bias tool were used for the qualitative appraisal.
Results: Nineteen RCTs were selected for qualitative analysis. Nine studies involved intravenous, and 5 intramuscular administration of tramadol, while 5 evaluated submucosal infiltration with tramadol. Intravenous or intramuscular tramadol provided a weaker analgesic effect compared with non-steroidal anti-inflammatory drugs (NSAIDs), while intravenous tramadol induced an enhanced analgesic effect than oral tramadol. Parenteral administration of tramadol improved the quality of postoperative analgesia versus placebo. No notable adverse effects were recorded.
Conclusions: Parenteral or submucosal infiltration of tramadol constitutes an effective and safe alternative analgesic approach in surgical extraction of mandibular third molars, yet the nociceptive effect of this analgesic modality could not supersede that of NSAIDs.
期刊介绍：
Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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