Journal of dental anesthesia and pain medicine最新文献

{"title":"Efficacy of lidocaine-prilocaine combined with amitriptyline or <i>Acmella oleracea</i> in a liposomal cream for topical anesthesia: a randomized crossover clinical trial.","authors":"Michael Henrique Araujo Monteiro, Josilanny Araujo de Souza Alencar, Victor Augusto Benedicto Dos Santos, Francisco Carlos Groppo, Camila Batista da Silva de Araujo Candido, Sidney Raimundo Figueroba","doi":"10.17245/jdapm.2025.25.6.409","DOIUrl":"10.17245/jdapm.2025.25.6.409","url":null,"abstract":"<p><strong>Background: </strong>Pain remains one of the main causes of apprehension during dental procedures. In this context, topical anesthetics play an essential role in reducing discomfort, and new compounds such as amitriptyline and jambu (<i>Acmella oleracea</i>) extract have been investigated as promising alternatives. Drug delivery systems, such as Pentravan^®, a nanosomal transdermal base, are also of interest; however, their application on oral mucosa has not yet been clinically evaluated. Therefore, this study aimed to compare the anesthetic efficacy of lidocaine (LDC) and prilocaine (PLC) combined with either amitriptyline or jambu, formulated as ointments or incorporated into Pentravan^®, for topical anesthesia of the buccal and palatal mucosa of maxillary premolars, using pulpal response and puncture sensitivity as outcome measures.</p><p><strong>Methods: </strong>A randomized, blinded, crossover clinical trial was conducted with 40 healthy volunteers who received six formulations: (1) LDC 2.5% + PLC 2.5% (positive control); (2) LDC 2.5% + PLC 2.5% + amitriptyline 5%; (3) LDC 2.5% + PLC 2.5% + jambu extract 20% (7.5% spilanthol); (4) LDC 2.5% + PLC 2.5% + amitriptyline 5% in Pentravan^®; (5) LDC 2.5% + PLC 2.5% + jambu extract 20% in Pentravan^®; and (6) base ointment without active ingredients (placebo). Pain upon needle puncture was assessed using the visual analog scale, and pulpal anesthesia was evaluated with an electric pulp tester.</p><p><strong>Results: </strong>Formulations 1 and 2 produced the lowest pain scores in the buccal mucosa, with Formulation 1 showing statistically superior results than Formulations 3, 4, 5, and 6 (P < 0.05). Formulation 6 yielded the highest pain scores, while Formulations 2-5 demonstrated intermediate efficacy without significant differences. Formulations 1 and 2 were also the most effective on the palatal mucosa. None of the formulations achieved significant pulpal anesthesia. Adverse effects were mild and self-limiting, with mucosal desquamation observed only with Formulation 2.</p><p><strong>Conclusion: </strong>Amitriptyline demonstrated relevant clinical potential, whereas jambu extract showed intermediate efficacy. Pentravan^®-based formulations did not exhibit clinical superiority. Future studies should focus on optimizing these combined formulations to enhance the efficacy of topical anesthesia in dentistry.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"409-420"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine as an adjunct to local anesthetics for impacted third molar surgery: a systematic review and meta-analysis.","authors":"Malik Alkabazi, Ebtesam Aldieb, Heba Hussein, Selvakumar Haridoss, Melek Tassoker, Gustavo Vicentis Oliveira Fernandes","doi":"10.17245/jdapm.2025.25.6.371","DOIUrl":"10.17245/jdapm.2025.25.6.371","url":null,"abstract":"<p><p>Recent studies have investigated the use of dexmedetomidine (DEX) as an adjuvant to local anesthetic solutions. Building on this emerging evidence, this study aimed to assess the efficacy of adding DEX to local anesthetics in patients undergoing impacted third molar surgery. A systematic search was conducted across four electronic databases, PubMed, ScienceDirect, Web of Science, and the Cochrane Library, using a combination of Medical Subject Headings terms and free-text keywords related to impacted third molar surgery. Six studies comprising 266 patients were included in the qualitative systematic review, and only four of them, involving 200 patients, were included in the quantitative meta-analysis. The random-effects model demonstrated statistically significant reductions in anesthetic onset time (mean difference [MD] = -0.96 min; 95% confidence interval [CI]: -1.52 to -0.39; P = 0.0009), systolic blood pressure (MD = -3.58 mmHg; 95% CI: -6.58 to -0.58; P = 0.020), and pain at 6 and 12 h postoperatively (MD = -2.32, 95% CI: -2.85 to -1.78; P = 0.0001) in the local anesthesia + DEX group compared with local anesthesia alone. The findings indicated that incorporating DEX into local anesthesia for impacted third molar surgery resulted in statistically significant improvements in the onset of anesthetic effects and postoperative pain scores.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"371-385"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12688002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological and psychomotor effectiveness of rapid and slow induction of nitrous oxide inhalation sedation in pediatric patients undergoing dental procedures: a randomized clinical study.","authors":"Sneha Chandulal Dori, Anshula N Deshpande, Simron Baishya, Vidhi Jaiswal, Sakshi Mishra, Medha Wadhwa","doi":"10.17245/jdapm.2025.25.6.387","DOIUrl":"10.17245/jdapm.2025.25.6.387","url":null,"abstract":"<p><strong>Background: </strong>Nitrous oxide-oxygen (N₂O:O₂) inhalation sedation is a safe and effective technique for managing dental anxiety and achieving light conscious sedation. It increases the pain threshold, reduces fatigue, and improves patient cooperation. Two primary induction techniques are used: slow and rapid induction, with the latter preferred for highly anxious or uncooperative patients who require immediate sedation during dental procedures. This study aimed to evaluate the efficacy of different concentrations of N₂O:O₂ inhalation sedation and to assess changes in physiological and psychomotor parameters, and post-sedation recovery, in pediatric patients.</p><p><strong>Methods: </strong>A total of 78 children who met the inclusion criteria were randomly divided into three groups: Group A (conventional slow induction), Group B (rapid induction with 30:70 N₂O:O₂), and Group C (rapid induction with 50:50 N₂O:O₂). Demographic and medical data were recorded. Baseline vital signs and the Trieger Dot Test were performed before treatment. Induction was carried out according to group protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) pain score and the Observer's Assessment of Alertness/Sedation (OAA/S) scale were used to assess pain and sedation levels, respectively. Vital signs were monitored during and after treatment. Post-recovery, the Trieger Dot Test was repeated, and a 24-hour follow-up call was made to assess the child's well-being.</p><p><strong>Results: </strong>All groups maintained vital signs within normal limits. Differences in pain perception and psychomotor impairment were statistically non-significant. A statistically significant difference was observed in the sedation levels among the groups (P = 0.033). Light sedation was achieved in 69.23%, 57.69%, and 73.08% of participants in Groups A, B, and C, respectively, while moderate sedation was observed in 19.23% of participants in the 50:50 induction group. A 24-hour telephonic follow-up revealed that all children had resumed normal activities and daily routines.</p><p><strong>Conclusion: </strong>The results provide clinicians with evidence-based guidance on N₂O:O₂ titration and induction techniques. The preadjusted mixture of 30% N₂O and 70% O₂ offers a more efficient approach to achieving an adequate depth of sedation in a shorter period while increasing pain tolerance. Therefore, it can serve as an effective alternative to slow induction for administering N₂O:O₂ inhalation sedation in restless and anxious pediatric patients.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"387-398"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12688009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete recovery from chronic implant-induced paresthesia after implant removal: a case report.","authors":"Ji Hyun Paik, Nan Ju Lee, Junglim Choi, Tae Min You, Seung-Rye Song","doi":"10.17245/jdapm.2025.25.6.451","DOIUrl":"10.17245/jdapm.2025.25.6.451","url":null,"abstract":"<p><p>Inferior alveolar nerve (IAN) injury is one of the most significant adverse outcomes of dental implantation. IAN injury can occur because of direct invasion of the mandibular canal, compression from implant placement, or postoperative hematoma formation. These injuries may result in prolonged neurosensory disturbances, and the prognosis largely depends on how quickly treatment is initiated. A 71-year-old male presented with persistent hypoesthesia, pain, and tinnitus in the left mandibular region of 6 years duration after implant placement. Clinical and radiographic examinations revealed peri-implantitis around the implant in the affected region. Neurosensory disturbances completely resolved after removal of the affected implant with peri-implantitis. This case highlights the fact that even long-standing inferior alveolar nerve injuries may be reversible if the underlying cause is resolved. Prompt recognition and elimination of etiologic factors such as implant-induced nerve compression in the presence of peri-implant pathology are crucial for achieving favorable recovery in patients with chronic IAN injury.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"451-456"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic trigeminal neuropathy following third molar extraction due to retromolar canal injury: a case report.","authors":"Pavithra Manohar, Samarjit Dey, Anuvindha Js, Jitendra Chawla","doi":"10.17245/jdapm.2025.25.6.443","DOIUrl":"10.17245/jdapm.2025.25.6.443","url":null,"abstract":"<p><p>The inferior alveolar nerve block (IANB) is the most frequently used mandibular nerve block in oral surgery; however, it has a reported failure rate of 15%-45%. The presence of the retromolar canal (RMC) and nerve, an anatomical variation in the mandibular retromolar region, can cause IANB failure. Although its occurrence is variable, the canal has gained increasing clinical relevance because of its vulnerability during oral and maxillofacial surgical procedures. Its presence may result in anesthetic failure during IANB and, less commonly, may act as a conduit for spreading infection or tumor metastasis. Although several studies have examined the prevalence and anatomical variations of the RMC, literature specifically addressing the traumatic neuropathy from injury to this area during third-molar extraction is lacking. This case report details post-traumatic trigeminal neuropathy following injury to the RMC during third-molar extraction. The case findings contribute to the limited clinical evidence, emphasize the importance of preoperative identification of anatomical variations, and underscore the need for meticulous intraoperative management to minimize the risk of iatrogenic neuropathic complications.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"443-449"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yet another report of endotracheal tube herniation through the Doughty blade of the Boyle-Davis Gag! Call for action.","authors":"Merlin Shalini Ruth S, Raghuraman M Sethuraman","doi":"10.17245/jdapm.2025.25.6.457","DOIUrl":"10.17245/jdapm.2025.25.6.457","url":null,"abstract":"","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 6","pages":"457-459"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of camouflaged and insulin syringes with and without counter-stimulation on anxiety and behavior in children during administration of local anesthesia.","authors":"Aditi Hagwane, Dinesh Rao, Sunil Panwar, Surbhi Sharma, Manan Phalke","doi":"10.17245/jdapm.2025.25.5.353","DOIUrl":"10.17245/jdapm.2025.25.5.353","url":null,"abstract":"<p><strong>Background: </strong>Fear of injections and dental anxiety are the major barriers to successful pediatric dental treatment. Visual threats associated with conventional syringes can increase anxiety and pain perception in children, necessitating the use of child-friendly strategies. This study aimed to evaluate and compare the impact of camouflaged and insulin syringes, with and without counter-stimulation, on anxiety levels, pain perception, and behavioral responses during local anesthesia administration in children.</p><p><strong>Methods: </strong>A clinical trial involving 120 children aged 8-10 years who required bilateral maxillary local anesthesia was performed. Local anesthesia with camouflaged and insulin syringes was administered to each child once with and without thumb pressure counter-stimulation. Anxiety was measured using pulse rates, pain was measured using the Wong-Baker Faces Pain Rating Scale, and behavior was measured using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Statistical analyses were performed using the independent t-test and chi-square test.</p><p><strong>Results: </strong>Both groups were demographically comparable with no significant differences in age (independent t-test, P = 0.539) or sex distribution (chi-square test, P = 0.854). At first appointment, camouflaged syringes showed significantly lower pain scores (3.58 ± 0.74 vs. 4.17 ± 1.37; P = 0.005), lower pulse rates (89.10 ± 5.84 vs. 99.00 ± 1.80 bpm; P < 0.001), and better behavioral responses (FLACC score: 2.27 ± 0.78 vs. 2.80 ± 0.68; P < 0.001) compared with insulin syringes, as assessed by the independent t-test. These effects were further enhanced by counter-stimulation. At second appointment, although overall scores improved in both groups, post-treatment differences between the syringe types were not statistically significant (P > 0.05).</p><p><strong>Conclusion: </strong>Camouflaged syringes combined with counter stimulation represent an effective, simple, and non-pharmacological method for reducing anxiety and improving cooperation during local anesthesia administration in pediatric dental patients. However, the findings are limited by the use of a homogenous sample of healthy, cooperative children aged 8-10 years and potential bias due to the inability of blind operators or participants. Future studies should evaluate a broader population and incorporate blind assessment protocols.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 5","pages":"353-362"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of two behavior guidance techniques in reducing pain perception and anxiety during local anesthesia administration in children: a randomized clinical trial.","authors":"Praveena Kavanoor, Svsg Nirmala","doi":"10.17245/jdapm.2025.25.5.327","DOIUrl":"10.17245/jdapm.2025.25.5.327","url":null,"abstract":"<p><strong>Background: </strong>The combination of local anesthesia (LA) and distraction techniques effectively reduces procedural pain and anxiety, enhance cooperation, and promote positive dental experiences in children. This study aimed to evaluate the effectiveness of the Hands-Eyes-Mouth Distraction Technique (HEM-DT) and the Covering Patient's Vision Technique (CPV-T) on pain perception and anxiety during local anesthesia administration in children aged 6-12 years.</p><p><strong>Methods: </strong>Fifty-two healthy children aged 6-12 years requiring LA were randomly allocated into two treatment groups: those receiving the HEM-DT, and those receiving the CPV-T. Anxiety was assessed subjectively using the Animated Emoji Scale before and after the intervention, while pulse rate was recorded using a pulse oximeter before, during, and after LA. Pain perception was measured during LA using the Sounds, Eyes, Motor (SEM) scale and after LA using the colored analog scale. Physiological data were analyzed using independent t-tests for intergroup comparisons, and paired t-tests with repeated-measures ANOVA for intragroup analysis. Wilcoxon signed-rank test was used to evaluate intragroup anxiety scores, and Mann-Whitney U test was used for intergroup comparisons of anxiety and pain scores.</p><p><strong>Results: </strong>Intragroup comparisons revealed statistically significant differences in pulse rates before, during, and after LA (P < 0.001). Intergroup comparisons also showed statistically significant differences in pulse rates during and after LA. Anxiety scores decreased significantly in the HEM-DT group (P < 0.001), which also had lower mean SEM and colored analogue scale pain scores than the CPV-T group (P < 0.001).</p><p><strong>Conclusion: </strong>HEM-DT was effective in reducing pain and anxiety during LA administration in children.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 5","pages":"327-338"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total intravenous sedation with target-controlled infusion in dentistry: clinical experience with the third-generation Eleveld pharmacokinetic/pharmacodynamic model.","authors":"Douglas Lobb, Masoud MiriMoghaddam, Don Macalister, Rohit Bedi, Keith Anderson, Hollis Lai","doi":"10.17245/jdapm.2025.25.5.313","DOIUrl":"10.17245/jdapm.2025.25.5.313","url":null,"abstract":"<p><strong>Background: </strong>Approximately 31% of adults experience dental anxiety, which represents a significant barrier to timely care and ultimately results in poor oral health outcomes. Moderate sedation is an effective method of managing anxiety while preserving patient responsiveness. Total intravenous anesthesia (TIVA) combined with target-controlled infusion (TCI) systems, which utilize pharmacokinetic models, enable precise control of drug delivery by maintaining stable effect-site concentrations. This study evaluated the safety and efficacy of moderate TCI-administered sedation using an Eleveld pharmacodynamic-pharmacokinetic model for propofol and remifentanil in dental practice.</p><p><strong>Methods: </strong>This prospective study included 114 patients who underwent dental procedures at two clinical sites. Moderate sedation was delivered via a TCI-guided Eleveld model, targeting the effect-site concentrations of propofol and remifentanil. The primary outcome was the incidence of adverse events as defined by the Tracking and Reporting Outcomes of Procedural Sedation criteria. The secondary outcomes included procedural duration, drug dosing, vital sign fluctuations, and patient-reported satisfaction.</p><p><strong>Results: </strong>After 7725 min of sedation, no adverse events were reported according to the TROOPS criteria. None of the patients experienced hypoxia (SpO₂ <90%), bradycardia (HR < 40 bpm), or clinical over-sedation. Hypotension (MAP < 65 mmHg) occurred in 13 patients who were managed conservatively without intervention. The average recovery time was 10.1 ± 5.2 min. Patient satisfaction was high (99%), with 93.6% of patients reporting little to no recall of the procedure.</p><p><strong>Conclusions: </strong>TCI-based moderate sedation using the Eleveld model for propofol and remifentanil is safe, effective, and well-tolerated in dental settings. The model offers predictable sedation depth, rapid recovery, and high levels of patient satisfaction, supporting its broader implementation in the management of dental anxiety.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 5","pages":"313-325"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zinc supplementation for postoperative sore throat prevention: evidence from a systematic review and meta-analysis.","authors":"Sumit Bansal, Siddhartha Dutta, Rima B Shah, Sunit Kumar Gupta, Shubha Singhal","doi":"10.17245/jdapm.2025.25.5.299","DOIUrl":"10.17245/jdapm.2025.25.5.299","url":null,"abstract":"<p><p>Postoperative sore throat (POST) is a frequent complication of tracheal intubation that compromises patient comfort and satisfaction. This is due to airway irritation and inflammation. Zinc, which is known for its anti-inflammatory and wound-healing effects, has been investigated as a preventive treatment for POST. This protocol was registered in PROSPERO (CRD420250651708).Three databases, PubMed, The Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov were searched using the keywords \"Post operative sore throat,\" and \"zinc.\" A literature search led to the retrieval of six clinical trials, of which three studies were included in the meta-analysis and all six studies were included in the systematic review. The data were synthesized using Cochrane Review Manager v.5.4.1. The Cochrane risk-of-bias 2.0 tool was used to assess the methodological quality of evidence. The pooled analysis included 248 patients (105 males and 143 females). Study findings suggested that zinc reduces the overall incidence of POST in comparison to placebo (P < 0.0001, OR = 0.29 [95% CI 0.16-0.53], I² = 0%). However, the effects of zinc on POST severity varied. The incidence of mild POST was significantly lower in the zinc-administered group at 0 (OR = 0.06 (95% CI 0.01-0.21), I² = 0%, P < 0.0001), 2 (OR = 0.27 (95% CI 0.13-0.57), I² = 0%, P = 0.0006) and 4 h (OR = 0.14 [95% CI 0.04-0.45], I² = 0%, P = 0.0010) post-extubation. There was no significant difference in the severity of moderate and severe POST between the zinc-supplemented group and the placebo group. Pooled analysis of our current evidence demonstrates that zinc significantly reduced the overall incidence of POST, with a maximum effect observed in mild POST.</p>","PeriodicalId":94330,"journal":{"name":"Journal of dental anesthesia and pain medicine","volume":"25 5","pages":"299-312"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}