Is Preemptive Analgesia Effective on Postoperative Complications Occurring After Impacted Third Molar Surgery under General Anaesthesia?
Abstract
Objective: In this study, it was aimed to retrospectively investigate the effects of preemptive analgesia on postoperative pain severity, pain onset time, analgesic need, edema and trismus caused by impacted third molar surgery.
Material and Methods: ASA I-II group who underwent third molar surgery under general anesthesia was given intravenous 0.3 mg/kg tenoxicam 20 minutes before the surgery and 20 minutes after the end of the surgery were completed under general anesthesia 0.3 mg/kg under the same standard. Patients who were given tenoxicam before the surgery obtained were divided into preemptive group (Group 1) and patients who were applied postoperative tenoxicam were divided into postoperative group (Group 2). The data records of the patients who were applied tenoxicam were examined.
Results: It was observed that the VAS values in the preemptive group were significantly lower than the values in the group 2 at the postoperative 1st, 3rd and 6th hours (p <0.05). It was found that 36 patients (76.6%) in the group 2 and 13 patients (31.0%) in the group 1 needed additional postoperative analgesia. Trismus was observed in 28 patients (59.6%) in the group 2 and 6 patients (14.2%) in the group 1. Analgesia time provided in the preemptive group was found to be significantly longer than the postoperative group (p <0.05).
Conclusion: We believe that preoperative analgesic application as part of multimodal analgesia in patients undergoing impacted third molar surgery under general anesthesia offers successful and reliable results in postoperative pain management.
Thanks
We would like to thanks to the staff and dental assistants, including our colleagues at the Adnan Menderes Unıversıty, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery.
References
- 1. Crile G: The kinetic theory of shock and its prevention through anoci-association (shockless operation). The Lancet 182:7-16, 1913.
- 2. Woolf CJ: Evidence for a central component of post-injury pain hypersensitivity. Nature 306:686-688, 1983.
- 3. Costa FWG, Esses DFS, de Barros Silva PG, Carvalho FSR, Sá CDL, Albuquerque AFM, Bezerra TP, Ribeiro TR, Fonteles CSR, Soares ECS: Does the preemptive use of oral nonsteroidal anti-inflammatory drugs reduce postoperative pain in surgical removal of third molars? A meta-analysis of randomized clinical trials. Anesthesia progress 62:57-63, 2015.
- 4. Mello FW, Melo G, Kammer PV, Speight PM, Rivero ERC: Prevalence of odontogenic cysts and tumors associated with impacted third molars: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery 47:996-1002, 2019.
- 5. Esparza-Villalpando V, Chavarria-Bolaños D, Gordillo-Moscoso A, Masuoka-Ito D, Martinez-Rider R, Isiordia-Espinoza M, Pozos- Guillen A: Comparison of the analgesic efficacy of preoperative/ postoperative oral dexketoprofen trometamol in third molar surgery: A randomized clinical trial. Journal of Cranio- Maxillofacial Surgery 44:1350-1355, 2016.
- 6. Kissin I: Preemptive analgesia. Anesthesiology: The Journal of the American Society of Anesthesiologists 93:1138-1143, 2000.
- 7. Kara İ, Tuncer S, Erol A, Reisli R: Preemptif deksketoprofen kullanımının postoperatif ağrı ve tramadol tüketimine etkisi. Ağrı 23:18-21, 2011.
- 8. Gopalraju P, Lalitha RM, Prasad K, Ranganath K: Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery–A prospective randomized study. Journal of Cranio-Maxillofacial Surgery 42:629-633, 2014.
- 9. Chang W-K, Wu H-L, Yang C-S, Chang K-Y, Liu C-L, Chan K-H, Sung C-S: Effect on pain relief and inflammatory response following addition of tenoxicam to intravenous patient-controlled morphine analgesia: a double-blind, randomized, controlled study in patients undergoing spine fusion surgery. Pain Medicine 14:736-748, 2013.
- 10. Pandit MK, Godhi S, Lall AB: Preoperative intravenous tramadol versus diclofenac for preventing postoperative pain after third molar surgery: a comparative study. Journal of maxillofacial and oral surgery 10:306-309, 2011.
- 11. Yağar S, Turan SK, Ayık İ, Güçlü ÇY, Koç M, Kantaroğlu S, Özgök A: Comparative Study of Pre-Emptive and Postoperative iv Tenoxicam in Laparoscopic Cholecystectomy. Journal of the Turkish Anaesthesiology & Intensive Care Society-JTAICS/Türk Anestezi ve Reanimasyon Dergisi 39:2011.
- 12. Ilhan O, Agacayak KS, Gulsun B, Koparal M, Gunes N: A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 20:147, 2014.
- 13. Saraswat V, Arora V: Preemptive gabapentin vs pregabalin for acute postoperative pain after surgery under spinal anaesthesia. Indian journal of anaesthesia 52:829, 2008.
- 14. Shah R, Mahajan A, Shah N, Dadhania AP: Preemptive analgesia in third molar impaction surgery. National journal of maxillofacial surgery 3:144, 2012.
- 15. Cebi AT, Kasapoğlu MB, Eren S, Kasapoğlu Ç: Comparison of the e ects of diclofenac potassium and tenoxicam on postoperative pain, swelling, and trismus following third molar surgery. Turkish journal of medical sciences 48:271-278, 2018.
- 16. Hupp JR, Tucker MR, Ellis E: Contemporary oral and maxillofacial surgery-e-book. Elsevier Health Sciences.
- 17. Moore PA, Brar P, Smiga ER, Costello BJ: Preemptive rofecoxib and dexamethasone for prevention of pain and trismus following third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 99:E1-E7, 2005.
- 18. Møiniche S, Kehlet H, Dahl JB: A Qualitative and Quantitative Systematic Review of Preemptive Analgesia for Postoperative Pain ReliefThe Role of Timing of Analgesia. Anesthesiology: The Journal of the American Society of Anesthesiologists 96:725-741, 2002.
Preemptif analjezi uygulamasının gömülü üçüncü molar diş cerrahisi sonrası oluşan postoperatif ağrı üzerine etkili midir?
Abstract
Amaç: Bu çalışmada, preemptif analjezinin gömülü üçüncü molar cerrahisine bağlı postoperatif ağrı şiddeti, ağrı başlangıç süresi, analjezik ihtiyacı, ödem ve trismus üzerine etkilerinin retrospektif olarak araştırılması amaçlandı.
Gereç ve Yöntemler: Genel anestezi altında 3. molar cerrahisi yapılan ASA I-II grubuna, ameliyattan 20 dakika önce ve ameliyat bitiminden 20 dakika sonra intravenöz 0,3 mg/kg tenoksikam verildi ve operasyon 0,3 mg/kg genel anestezi altında tamamlandı. aynı standart. Ameliyat öncesinde tenoksikam verilen hastalar preemptif gruba (Grup 1), postoperatif tenoksikam uygulanan hastalar ise postoperatif gruba (Grup 2) ayrıldı. Tenoksikam uygulanan hastaların veri kayıtları incelendi.
Bulgular: Preemptif gruptaki VAS değerlerinin ameliyat sonrası 1., 3. ve 6. saatlerde grup 2'ye göre anlamlı derecede düşük olduğu görüldü (p<0,05). Grup 2'de 36 (%76,6) hastanın, grup 1'de ise 13 (%31,0) hastanın ameliyat sonrası ek analjeziye ihtiyaç duyduğu belirlendi. Grup 2'de 28 (%59,6) hastada, grup 1'de ise 6 (%14,2) hastada trismus görüldü. Preemptif grupta sağlanan analjezi süresinin postoperatif gruba göre anlamlı olarak daha uzun olduğu görüldü (p<0,05).
Sonuç: Genel anestezi altında gömülü üçüncü molar cerrahisi uygulanan hastalarda multimodal analjezinin bir parçası olarak preoperatif analjezik uygulamasının postoperatif ağrı tedavisinde başarılı ve güvenilir sonuçlar sunduğuna inanıyoruz.
References
- 1. Crile G: The kinetic theory of shock and its prevention through anoci-association (shockless operation). The Lancet 182:7-16, 1913.
- 2. Woolf CJ: Evidence for a central component of post-injury pain hypersensitivity. Nature 306:686-688, 1983.
- 3. Costa FWG, Esses DFS, de Barros Silva PG, Carvalho FSR, Sá CDL, Albuquerque AFM, Bezerra TP, Ribeiro TR, Fonteles CSR, Soares ECS: Does the preemptive use of oral nonsteroidal anti-inflammatory drugs reduce postoperative pain in surgical removal of third molars? A meta-analysis of randomized clinical trials. Anesthesia progress 62:57-63, 2015.
- 4. Mello FW, Melo G, Kammer PV, Speight PM, Rivero ERC: Prevalence of odontogenic cysts and tumors associated with impacted third molars: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery 47:996-1002, 2019.
- 5. Esparza-Villalpando V, Chavarria-Bolaños D, Gordillo-Moscoso A, Masuoka-Ito D, Martinez-Rider R, Isiordia-Espinoza M, Pozos- Guillen A: Comparison of the analgesic efficacy of preoperative/ postoperative oral dexketoprofen trometamol in third molar surgery: A randomized clinical trial. Journal of Cranio- Maxillofacial Surgery 44:1350-1355, 2016.
- 6. Kissin I: Preemptive analgesia. Anesthesiology: The Journal of the American Society of Anesthesiologists 93:1138-1143, 2000.
- 7. Kara İ, Tuncer S, Erol A, Reisli R: Preemptif deksketoprofen kullanımının postoperatif ağrı ve tramadol tüketimine etkisi. Ağrı 23:18-21, 2011.
- 8. Gopalraju P, Lalitha RM, Prasad K, Ranganath K: Comparative study of intravenous Tramadol versus Ketorolac for preventing postoperative pain after third molar surgery–A prospective randomized study. Journal of Cranio-Maxillofacial Surgery 42:629-633, 2014.
- 9. Chang W-K, Wu H-L, Yang C-S, Chang K-Y, Liu C-L, Chan K-H, Sung C-S: Effect on pain relief and inflammatory response following addition of tenoxicam to intravenous patient-controlled morphine analgesia: a double-blind, randomized, controlled study in patients undergoing spine fusion surgery. Pain Medicine 14:736-748, 2013.
- 10. Pandit MK, Godhi S, Lall AB: Preoperative intravenous tramadol versus diclofenac for preventing postoperative pain after third molar surgery: a comparative study. Journal of maxillofacial and oral surgery 10:306-309, 2011.
- 11. Yağar S, Turan SK, Ayık İ, Güçlü ÇY, Koç M, Kantaroğlu S, Özgök A: Comparative Study of Pre-Emptive and Postoperative iv Tenoxicam in Laparoscopic Cholecystectomy. Journal of the Turkish Anaesthesiology & Intensive Care Society-JTAICS/Türk Anestezi ve Reanimasyon Dergisi 39:2011.
- 12. Ilhan O, Agacayak KS, Gulsun B, Koparal M, Gunes N: A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 20:147, 2014.
- 13. Saraswat V, Arora V: Preemptive gabapentin vs pregabalin for acute postoperative pain after surgery under spinal anaesthesia. Indian journal of anaesthesia 52:829, 2008.
- 14. Shah R, Mahajan A, Shah N, Dadhania AP: Preemptive analgesia in third molar impaction surgery. National journal of maxillofacial surgery 3:144, 2012.
- 15. Cebi AT, Kasapoğlu MB, Eren S, Kasapoğlu Ç: Comparison of the e ects of diclofenac potassium and tenoxicam on postoperative pain, swelling, and trismus following third molar surgery. Turkish journal of medical sciences 48:271-278, 2018.
- 16. Hupp JR, Tucker MR, Ellis E: Contemporary oral and maxillofacial surgery-e-book. Elsevier Health Sciences.
- 17. Moore PA, Brar P, Smiga ER, Costello BJ: Preemptive rofecoxib and dexamethasone for prevention of pain and trismus following third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 99:E1-E7, 2005.
- 18. Møiniche S, Kehlet H, Dahl JB: A Qualitative and Quantitative Systematic Review of Preemptive Analgesia for Postoperative Pain ReliefThe Role of Timing of Analgesia. Anesthesiology: The Journal of the American Society of Anesthesiologists 96:725-741, 2002.
Details
| Primary Language | English |
|---|---|
| Subjects | Facial Plastic Surgery, Surgery (Other) |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | May 15, 2024 |
| Publication Date | May 19, 2024 |
| Submission Date | October 31, 2023 |
| Acceptance Date | December 28, 2023 |
| Published in Issue | Year 2024 Volume: 3 Issue: 2 |
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