Journal of Dental Anesthesia and Pain Medicine

  • 제22권6호
  • /
  • Pages.443-450
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  • 2022
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  • 2383-9309(pISSN)
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  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
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Pre-emptive analgesia efficacy of piroxicam versus tramadol in oral surgery

  • Tejdeep, Muthuluri (Department of Oral & Maxillofacial Surgery, SVS Institute of Medical & Dental Sciences) ;
  • Siddardha Gowtam, Chandrupatla (Public Health Dentist, Ibn Sina Foundation) ;
  • Ritesh, Rajan (Department of Oral & Maxillofacial Surgery, SVS Institute of Medical & Dental Sciences) ;
  • Viveka V., Reddy (Department of Oral & Maxillofacial Surgery, SVS Institute of Medical & Dental Sciences) ;
  • Dinesh K., Jhawar (Department of Oral & Maxillofacial Surgery, SVS Institute of Medical & Dental Sciences) ;
  • Abhinand, Potturi (Department of Oral & Maxillofacial Surgery, SVS Institute of Medical & Dental Sciences)
  • 투고 : 2022.07.19
  • 심사 : 2022.10.07
  • 발행 : 2022.12.01
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초록

Background: This double-blind randomized controlled trial (RCT) was conducted to evaluate the pre-emptive analgesia and anti-inflammatory efficacy of piroxicam compared with tramadol in patients undergoing oral surgery. Methods: Seventy-eight patients who required extraction of impacted mandibular third molars were randomized into three treatment groups of 26 patients each: group I received 100 mg of tramadol, group II received 20 mg of piroxicam, and group III received a placebo. Drugs were administered intramuscularly 30 min prior to the extraction procedure. Results: Pain intensity, time to first analgesic administration, total analgesic consumption, facial edema, and trismus were the outcomes of interest. The group receiving 20 mg of piroxicam showed significantly lower pain intensity, increased time to first analgesic, and reduced edema from preoperative to postoperative day seven than those in the tramadol and placebo groups. Conclusion: The findings of this study showed that piroxicam had significant pain relief efficacy after third molar surgery compared with that in tramadol.

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참고문헌

  1. Woolf CJ. Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med 2004; 140: 441-51. https://doi.org/10.7326/0003-4819-140-8-200404200-00010
  2. Kanto D, Salo M, Happonen RP, Vahlberg T, Kanto J. Tramadol premedication in operative extraction of the mandibular third molar: a placebo-controlled crossover study. Acta Odontol Scand 2005; 63: 43-9. https://doi.org/10.1080/00016350510019685
  3. Zacharias M, Hunter KM, Baker AB. Effectiveness of preoperative analgesics on postoperative dental pain: a study. Anesth Prog 1996; 43: 92-6.
  4. Desjardins PJ. Analgesic efficacy of piroxicam in postoperative dental pain. Am J Med 1988; 84: 35-41. https://doi.org/10.1016/0002-9343(88)90475-5
  5. Hutchison GL, Crofts SL, Gray IG. Preoperative piroxicam for postoperative analgesia in dental surgery. Br J Anaesth 1990; 65: 500-3. https://doi.org/10.1093/bja/65.4.500
  6. Isiordia-Espinoza MA, Pozos-Guillen A, Martinez-Rider R, Perez-Urizar J. Comparison of the analgesic efficacy of oral ketorolac versus intramuscular tramadol after third molar surgery: a parallel, double-blind, randomized, placebo- controlled clinical trial. Med Oral Patol Oral Cir Bucal 2016; 21: e637-43.
  7. Ong KS, Tan JML. Preoperative intravenous tramadol versus ketorolac for preventing postoperative pain after third molar surgery. Int J Oral Maxillofac Surg 2004; 33: 274-8. https://doi.org/10.1006/ijom.2003.0515
  8. Shah AV, Arun Kumar KV, Rai KK, Rajesh Kumar BP. Comparative evaluation of pre-emptive analgesic efficacy of intramuscular ketorolac versus tramadol following third molar surgery. J Maxillofac Oral Surg 2013; 12: 197-202. https://doi.org/10.1007/s12663-012-0420-4
  9. da Costa Araujo FA, de Santana Santos T, de Morais HH, Laureano Filho JR, de Oliveira E Silva ED, Vasconcellos RJ. Comparative analysis of preemptive analgesic effect of tramadol chlorhydrate and nimesulide following third molar surgery. J Craniomaxillofac Surg 2012; 40: e346-9. https://doi.org/10.1016/j.jcms.2012.01.018
  10. Isiordia-Espinoza MA, Pozos-Guillen AJ, Martinez-Rider R, Herrera-Abarca JE, Perez-Urizar J. Preemptive analgesic effectiveness of oral ketorolac plus local tramadol after impacted mandibular third molar surgery. Med Oral Patol Oral Cir Bucal 2011; 16: e776-80.
  11. Ruhter L, Juhascik M, Watson J, Sweeney K, Daniulaityte R. Tramadol in seized drugs containing non-pharmaceutical fentanyl: crime lab data from Ohio, USA. Emerg Trends Drugs Addict Health 2022; 2: 100042.
  12. Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R. Trends in tramadol: pharmacology, metabolism, and misuse. Anesth Analg 2017; 124: 44-51. https://doi.org/10.1213/ANE.0000000000001683
  13. Saapiire F, Namillah G, Tanye V, Abubakari A. The insurgence of tramadol abuse among the most active population in jirapa municipality: a study to assess the magnitude of the abuse and its contributory factors. Psychiatry J 2021; 2021: 3026983.
  14. Salm-Reifferscheidt L. Tramadol: Africa's opioid crisis. Lancet 2018; 391: 1982-3. https://doi.org/10.1016/S0140-6736(18)31073-0
  15. Bali A, Bali D, Sharma A, Verma G. Is pederson index a true predictive difficulty index for impacted mandibular third molar surgery? A meta-analysis. J Maxillofac Oral Surg 2013; 12: 359-64. https://doi.org/10.1007/s12663-012-0435-x
  16. Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Can J Anaesth 2001; 48: 1000-10. https://doi.org/10.1007/BF03016591
  17. 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. J Craniomaxillofac Surg 2014; 42: 629-33. https://doi.org/10.1016/j.jcms.2013.09.004
  18. Trindade PA, Giglio FP, Colombini-Ishikiriama BL, Calvo AM, Modena KC, Ribeiro DA, et al. Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction. Int J Oral Maxillofac Surg 2011; 40: 292-7. https://doi.org/10.1016/j.ijom.2010.10.026
  19. Isiordia-Espinoza MA, Sanchez-Prieto M, Tobias-Azua F, Reyes-Garcia JG. Pre-emptive analgesic effectiveness of meloxicam versus tramadol after mandibular third molar surgery: a pilot study. J Oral Maxillofac Surg 2012; 70: 31-6. https://doi.org/10.1016/j.joms.2011.03.039
  20. Barbalho JC, Vasconcellos RJ, de Morais HH, Santos LA, Almeida RA, Rebelo HL, et al. Effects of co-administered dexamethasone and nimesulide on pain, swelling, and trismus following third molar surgery: a randomized, triple-blind, controlled clinical trial. Int J Oral Maxillofac Surg 2017; 46: 236-42.
  21. Balihallimath LJ, Shruti SP. Sublingual piroxicam for management of postoperative pain, trismus and swelling after extraction of lower third molars: an overview. IOSR J Dent Med Sci 2015; 14: 80-2.
  22. Moore PA, Brar P, Smiga ER, Costello BJ. Preemptive rofecoxib and dexamethasone for prevention of pain and trismus following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: E1-7. https://doi.org/10.1016/j.tripleo.2004.08.028
  23. Trindade PA, Giglio FP, Colombini-Ishikiriama BL, Calvo AM, Modena KC, Ribeiro DA, et al. Sublingual ketorolac and sublingual piroxicam are equally effective for postoperative pain, trismus, and swelling management in lower third molar removal. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 27-34. https://doi.org/10.1016/j.tripleo.2011.05.027
  24. Fisher SE, Frame JW, Rout PG, McEntegart DJ. Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br Dent J 1988; 164: 351-4. https://doi.org/10.1038/sj.bdj.4806453
  25. Khorshidi Khiavi R, Pourallahverdi M, Pourallahverdi A, Ghorani Khiavi S, Ghertasi Oskouei S, Mokhtari H. Pain control following impacted third molar surgery with bupivacaine irrigation of tooth socket: a prospective study. J Dent Res Dent Clin Dent Prospects 2010; 4: 105-9. https://doi.org/10.5681/joddd.2010.027
  26. Ong CKS, Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res 2007; 5: 19-34. https://doi.org/10.3121/cmr.2007.698
  27. Isiordia-Espinoza MA, de Jesus Pozos-Guillen A, Aragon-Martinez OH. Analgesic efficacy and safety of single-dose tramadol and non-steroidal anti-inflammatory drugs in operations on the third molars: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2014; 52: 775-83.  https://doi.org/10.1016/j.bjoms.2014.05.005