PREEMPTIVE INTRAVENOUS IBUPROFEN AND LOCAL KETAMINE IMPROVE POSTOPERATIVE ANALGESIA FOLLOWING THIRD MOLAR SURGERY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL STUDY

IF 4.1 4区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
CIHAN TOPAN, MUSTAFA KARAKAYA, AHMET EMIN DEMIRBAŞ, SUHEYB BILGE, DILEK GÜNAY CANPOLAT
{"title":"PREEMPTIVE INTRAVENOUS IBUPROFEN AND LOCAL KETAMINE IMPROVE POSTOPERATIVE ANALGESIA FOLLOWING THIRD MOLAR SURGERY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL STUDY","authors":"CIHAN TOPAN,&nbsp;MUSTAFA KARAKAYA,&nbsp;AHMET EMIN DEMIRBAŞ,&nbsp;SUHEYB BILGE,&nbsp;DILEK GÜNAY CANPOLAT","doi":"10.1016/j.jebdp.2023.101957","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare the efficacy of preemptive ibuprofen, local ketamine, and their combination in managing postoperative pain and trismus following third molar surgery.</p></div><div><h3>Materials and Methods</h3><p>One hundred patients were randomly divided into 4 groups. The Intrafen Group had their impacted third molars surgically removed under local anesthesia after receiving intravenous (IV) ibuprofen for preemptive effect. The Ketamine Group received an IV placebo before the surgery, and the extraction process was completed with a local anesthetic-ketamine combination. The Combined Group received preemptive IV ibuprofen before the procedure, and the surgery was performed with a local anesthetic-ketamine combination. The Control Group received an IV placebo before the procedure and then had their impacted third molars removed under local anesthesia. The Visual Analogue Scale (VAS) values, corresponding to the patients' pain levels at the 2nd and 12th postoperative hours and the total amount of analgesic dose used in the first 24 hours, were recorded, and evaluated. The maximum mouth opening of the patients was measured immediately before the procedure, and on the second and seventh postoperative days. The level of patient satisfaction in all groups was assessed during the procedure.</p></div><div><h3>Results</h3><p>The mean VAS value corresponding to the second-hour pain level of the combined group was statistically significantly lower than the other groups (<em>P</em> = .003). A statistically significant difference was found in the mean VAS values corresponding to the pain levels of the groups, favoring the combined group compared to the other groups (<em>P</em> ≤ .001). A significant difference was observed between the VAS difference values corresponding to the pain levels of the Intrafen group and the Ketamine group, favoring the Intrafen group (<em>P</em> = .038). The Ketamine group consumed the most analgesic on average over the first 24 hours, whereas the Combined group consumed the least. No statistically significant difference was found between the mean trismus levels of the groups on days 0-2 (<em>P</em> = .528) and days 0-7 (<em>P</em> = .129). The intraoperative patient satisfaction level of the combined group was significantly higher than that of the other groups (<em>P</em> = .030).</p></div><div><h3>Conclusion</h3><p>Preemptive Intrafen is an effective regimen for postoperative pain management and is superior to the local anesthetic-ketamine regimen. The most effective method to reduce postoperative pain following third molar surgery is to use a combination of these 2 regimens. However, none of the treatment methods used in the study had a positive effect on postoperative trismus.</p></div>","PeriodicalId":48736,"journal":{"name":"Journal of Evidence-Based Dental Practice","volume":"24 1","pages":"Article 101957"},"PeriodicalIF":4.1000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Evidence-Based Dental Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1532338223001677","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

To compare the efficacy of preemptive ibuprofen, local ketamine, and their combination in managing postoperative pain and trismus following third molar surgery.

Materials and Methods

One hundred patients were randomly divided into 4 groups. The Intrafen Group had their impacted third molars surgically removed under local anesthesia after receiving intravenous (IV) ibuprofen for preemptive effect. The Ketamine Group received an IV placebo before the surgery, and the extraction process was completed with a local anesthetic-ketamine combination. The Combined Group received preemptive IV ibuprofen before the procedure, and the surgery was performed with a local anesthetic-ketamine combination. The Control Group received an IV placebo before the procedure and then had their impacted third molars removed under local anesthesia. The Visual Analogue Scale (VAS) values, corresponding to the patients' pain levels at the 2nd and 12th postoperative hours and the total amount of analgesic dose used in the first 24 hours, were recorded, and evaluated. The maximum mouth opening of the patients was measured immediately before the procedure, and on the second and seventh postoperative days. The level of patient satisfaction in all groups was assessed during the procedure.

Results

The mean VAS value corresponding to the second-hour pain level of the combined group was statistically significantly lower than the other groups (P = .003). A statistically significant difference was found in the mean VAS values corresponding to the pain levels of the groups, favoring the combined group compared to the other groups (P ≤ .001). A significant difference was observed between the VAS difference values corresponding to the pain levels of the Intrafen group and the Ketamine group, favoring the Intrafen group (P = .038). The Ketamine group consumed the most analgesic on average over the first 24 hours, whereas the Combined group consumed the least. No statistically significant difference was found between the mean trismus levels of the groups on days 0-2 (P = .528) and days 0-7 (P = .129). The intraoperative patient satisfaction level of the combined group was significantly higher than that of the other groups (P = .030).

Conclusion

Preemptive Intrafen is an effective regimen for postoperative pain management and is superior to the local anesthetic-ketamine regimen. The most effective method to reduce postoperative pain following third molar surgery is to use a combination of these 2 regimens. However, none of the treatment methods used in the study had a positive effect on postoperative trismus.

先期静脉注射布洛芬和局部氯胺酮可改善第三磨牙手术后的镇痛效果:一项双盲、随机、安慰剂对照临床研究
材料与方法 100 名患者随机分为四组。Intrafen组在接受静脉注射布洛芬以达到预防效果后,在局部麻醉下通过手术拔除撞击性第三磨牙。氯胺酮组在手术前静脉注射安慰剂,然后用局部麻醉剂和氯胺酮组合完成拔牙过程。联合组在手术前静脉注射布洛芬,并使用氯胺酮组合局部麻醉剂完成手术。对照组在术前静脉注射安慰剂,然后在局部麻醉下拔除第三磨牙。记录并评估了术后第 2 小时和第 12 小时的视觉模拟量表(VAS)值、患者的疼痛程度以及头 24 小时的镇痛剂总用量。在手术前、术后第 2 天和第 7 天测量了患者的最大张口度。在手术过程中,对各组患者的满意度进行了评估。结果联合组患者第 2 小时疼痛程度的 VAS 平均值在统计学上显著低于其他组(P=0.003)。各组疼痛程度对应的 VAS 平均值在统计学上存在明显差异,联合组优于其他组(p≤ 0.001)。英特芬组和氯胺酮组疼痛程度的 VAS 差值有明显差异,英特芬组更优(p=0.038)。在最初的 24 小时内,氯胺酮组平均消耗的镇痛剂最多,而联合组消耗的镇痛剂最少。各组在第 0-2 天(P=0.528)和第 0-7 天(P=0.129)的平均肢体瘫痪程度在统计学上无明显差异。联合组的术中患者满意度明显高于其他组(P=0.030)。结论预防性 Intrafen 是一种有效的术后止痛方案,优于局麻药-氯胺酮方案。减少第三磨牙手术后疼痛的最有效方法是将这两种疗法结合使用。然而,该研究中使用的治疗方法均未对术后三联症产生积极影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Evidence-Based Dental Practice
Journal of Evidence-Based Dental Practice DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
6.00
自引率
16.70%
发文量
105
审稿时长
28 days
期刊介绍: The Journal of Evidence-Based Dental Practice presents timely original articles, as well as reviews of articles on the results and outcomes of clinical procedures and treatment. The Journal advocates the use or rejection of a procedure based on solid, clinical evidence found in literature. The Journal''s dynamic operating principles are explicitness in process and objectives, publication of the highest-quality reviews and original articles, and an emphasis on objectivity.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信