Efficacy of ketoprofen with or without omeprazole for pain and inflammation control after third molar removal

Abstract In view of the gastrointestinal problems generated by the ketoprofen use, the ketoprofen association with omeprazole is available on the market. However, this association efficacy in acute pain control has not been established. Bilateral extraction of lower third molars in similar positions is currently the most used model for the evaluation and investigation of the efficacy and pharmacological effects of new compounds for the treatment of acute postoperative pain. The randomized and crossover study consisted in evaluating the clinical efficacy of therapy performed by ketoprofen 100 mg (twice daily-b.i.d.) versus ketoprofen 200 mg + omeprazole 20 mg (once daily-q.d.) to pain, swelling and trismus control in the bilateral extraction model of lower third molars in similar positions in two different appointments, in 50 volunteers. Volunteers reported significantly less postoperative pain at various post-operative periods and consumed less rescue analgesic medication (acetaminophen 750 mg) throughout the study when they took the combination of ketoprofen 200 mg + omeprazole 20 mg (q.d.). Following administration of both study drugs, no gastrointestinal adverse reactions were reported by volunteers. Furthermore, the evaluations of the drugs in pain control by the volunteers were significantly favorable to ketoprofen 200 mg + omeprazole 20 mg (q.d.). For swelling and trismus control, the treatments presented similar results. In conclusion, when volunteers took ketoprofen 200 mg + omeprazole 20 mg (q.d.), they reported significantly less postoperative pain at various post-surgical periods and consumed less rescue analgesic medication throughout the study compared with ketoprofen 100 mg (b.i.d).

Resumo Em vista dos problemas gastrointestinais gerados pelo uso do cetoprofeno, a associação do cetoprofeno com o omeprazol está disponível no mercado. No entanto, esta eficácia de associação no controle da dor aguda não foi estabelecida. A extração bilateral de terceiros molares inferiores em posições semelhantes é atualmente o modelo mais utilizado para a avaliação e investigação da eficácia e efeitos farmacológicos de novos compostos para o tratamento da dor aguda pós-operatória. O estudo randomizado e cruzado consistiu na avaliação da eficácia clínica da terapia com cetoprofeno 100 mg (duas vezes ao dia-b.i.d.) versus cetoprofeno 200 mg + omeprazol 20 mg (uma vez ao dia-q.d.) para o controle da dor, do edema e do trismo no modelo bilateral de terceiros molares inferiores em posições semelhantes em duas consultas diferentes, em 50 voluntários. Os voluntários relataram significativamente menos dor pós-operatória em vários períodos pós-operatórios e consumiram menos medicação analgésica de socorro (acetaminofeno 750 mg) durante todo o estudo quando tomaram a combinação de 200 mg de cetoprofeno + 20 mg de omeprazol (q.d.). Após a administração de ambas as drogas do estudo, nenhuma reação adversa gastrointestinal foi relatada pelos voluntários. Além disso, as avaliações das drogas no controle da dor pelos voluntários foram significativamente favoráveis ​​ao cetoprofeno 200 mg + omeprazol 20 mg (q.d.). Para o controle do edema e do trismo, os tratamentos apresentaram resultados semelhantes. Em conclusão, quando os voluntários tomaram 200 mg de cetoprofeno + 20 mg de omeprazol (q.d.), eles relataram significativamente menos dor pós-operatória em vários períodos pós-cirúrgicos e consumiram menos medicação analgésica de socorro durante o estudo comparado com 100 mg de cetoprofeno (b.i.d).

The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.

The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.