在下第三磨牙手术中联合使用布洛芬-L-精氨酸和地塞米松的预防性与先发制人：随机对照试验

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-02-01 DOI:10.1016/j.oooo.2024.08.008

Edson Luiz Cetira-Filho DDS, MSc, PhD , Paulo Goberlânio de Barros Silva DDS, MSc, PhD , Isabelle de Fátima Vieira Camelo Maia CP , Deysi Viviana Tenazoa Wong MSc, PhD , Roberto César Pereira Lima-Júnior Sc, PhD , Ravy Jucá Farias DDS , Mayara Alves dos Anjos DDS student , Said Goncalves da Cruz Fonseca CP, MSc, PhD , Thyciana Rodrigues Ribeiro DDS, MSc, PhD , Fábio Wildson Gurgel Costa DDS, MSc, PhD

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引用次数: 0

摘要

目的：比较不同的抢先和预防性镇痛策略（包括口服联合给药布洛芬-精氨酸（770 毫克）-Ib-Ar 和地塞米松（8 毫克）-DX，以及各自的安慰剂（P-Ib-Ar 和 P-DX））、四个评估组对下第三磨牙手术后炎症和实验室参数、对生活质量的影响、疼痛灾难化感知和睡眠质量的影响。对 48 名志愿者进行了随机分口三盲对照临床试验。他们根据术前 1 小时或术后立即使用 Ib-Ar 或 DX 的情况进行分配，并区分为不同的组别：G1组（Ib-Ar + DX）、G2组（Ib-Ar + P-DX）、G3组（P-Ib-Ar + DX）和G4组（P-Ib-Ar + P-DX）。疼痛峰值出现在 2 小时后（P-Ib-Ar 组）（= .003），而其他组的疼痛峰值出现在 4 小时后（< .05）。关于水肿：使用安慰剂治疗的各组水肿明显减轻，没有恢复到基线水平 ( < .001)。关于实验室参数：MPO和MDA水平，G1组（< .001）是唯一出现显著下降的组别。使用 Ib-Ar 和 DX 的先期和预防性镇痛策略表明，联合使用可延缓疼痛峰值，而在水肿和肢体瘫痪方面没有差异。联合使用这两种策略的效果优于单独使用药物。

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Preemptive vs preventive coadministration of ibuprofen L-arginine and dexamethasone in lower third molar surgeries: a randomized controlled trial

Objective

To compare the effect of different preemptive and preventive analgesia strategies involving oral coadministration of ibuprofen-arginine (770 mg)–Ib-Ar and dexamethasone (8 mg)-DX, and their respective placebos (P-Ib-Ar and P-DX), four evaluation groups on inflammatory and laboratory parameters, impact on quality of life, pain catastrophizing perception and sleep quality related after lower third molar surgery.

Study Design

A randomized split-mouth, triple-blind, controlled clinical trial was conducted with 48 volunteers. They were allocated depending on the use of Ib-Ar or DX, 1 hour before surgery or immediately postoperatively, discriminating the groups: G1 (Ib-Ar + DX), G2 (Ib-Ar + P-DX), G3 (P-Ib-Ar + DX), and G4 (P-Ib-Ar + P-DX).

Results

Pain peaks occurred after 2 h (P-Ib-Ar groups) (P = .003), while the other groups showed peak pain after 4 h (P < .05). Regarding the edema: groups treated with placebos measurements significantly reduced without returning to baseline (P < .001). Regarding laboratory parameters: MPO and MDA levels, the G1 group (P < .001) was the only one showing significant reduction.

Conclusions

The use of preemptive and preventive analgesia strategies of Ib-Ar and DX showed that the combined use delayed peak pain, with no difference in edema and trismus. The benefit of coadministration of both strategies was superior to isolated use of drugs.

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.