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1.
Med Oral Patol Oral Cir Bucal ; 22(1): e122-e131, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27918744

RESUMO

BACKGROUND: Using a double-blinded randomized crossover design, this study aimed to evaluate acute postoperative pain management, swelling and trismus in 46 volunteers undergoing extractions of the two lower third molars, in similar positions, at two different appointments who consumed a tablet of either NE (naproxen 500 mg + esomepraz ole 20 mg) or only naproxen (500 mg) every 12 hours for 4 days. MATERIAL AND METHODS: Parameters were analyzed: self-reported pain intensity using a visual analog scale (VAS) pre- and postoperative mouth opening; incidence, type and severity of adverse reactions; total quantity consumed of rescue medication; and pre- and postoperative swelling. RESULTS: Female volunteers reported significantly more postoperative pain at 1, 1.5, 2, 3 and 4hrs after surgery while also taking their first rescue medication at a time significantly earlier when consuming NE when compared to naproxen (3.7hrs and 6.7hrs). Conversely, no differences were found between each drug group in males. CONCLUSIONS: In conclusion, throughout the entire study, pain was mild after using either drug in both men and women with pain scores on average well below 40mm (VAS), although in women naproxen improved acute postoperative pain management when compared to NE.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Esomeprazol/uso terapêutico , Inflamação/tratamento farmacológico , Dente Serotino/cirurgia , Naproxeno/uso terapêutico , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Extração Dentária , Adolescente , Adulto , Estudos Cross-Over , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
2.
Braz J Med Biol Res ; 40(8): 1133-40, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17665051

RESUMO

We compared the clinical efficacy of orally administered valdecoxib and piroxicam for the prevention of pain, trismus and swelling after removal of horizontally and totally intrabony impacted lower third molars. Twenty-five patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Valdecoxib (40 mg) or piroxicam (20 mg) was administered in a double-blind, randomized and crossed manner for 4 days after the surgical procedures. Objective and subjective parameters were recorded for comparison of postoperative courses. Both agents were effective for postoperative pain relief (N = 19). There was a similar mouth opening at suture removal compared with the preoperative values (86.14 +/- 4.36 and 93.12 +/- 3.70% of the initial measure for valdecoxib and piroxicam, respectively; ANOVA). There was no significant difference regarding the total amount of rescue medication taken by the patients treated with valdecoxib or piroxicam (173.08 +/- 91.21 and 461.54 +/- 199.85 mg, respectively; Wilcoxon test). There were no significant differences concerning the swelling observed on the second postoperative day compared to baseline measures (6.15 +/- 1.84 and 8.46 +/- 2.04 mm for valdecoxib and piroxicam, respectively; ANOVA) or on the seventh postoperative day (1.69 +/- 1.61 and 2.23 +/- 2.09 mm for valdecoxib and piroxicam, respectively; ANOVA). The cyclooxygenase-2 selective inhibitor valdecoxib is as effective as the non-selective cyclooxygenase inhibitor piroxicam for pain, trismus and swelling control after removal of horizontally and totally intrabony impacted lower third molars.


Assuntos
Inibidores de Ciclo-Oxigenase/uso terapêutico , Edema/tratamento farmacológico , Isoxazóis/uso terapêutico , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Piroxicam/uso terapêutico , Sulfonamidas/uso terapêutico , Trismo/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Extração Dentária , Resultado do Tratamento
3.
Int J Oral Maxillofac Surg ; 36(1): 26-31, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17112703

RESUMO

Fifty patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Meloxicam 7.5 or 15 mg was once daily administered in a double-blind, randomized and crossover manner after the surgery for 4 days. Objective and subjective parameters were recorded for comparison of postoperative courses. Patients treated with 7.5mg meloxicam who underwent osteotomy reported higher pain scores at 1.5, 3, 4, 10, 12 and 16 h (P<0.05) and ingested a greater amount of rescue analgesic medication (P<0.05) than those who did not require osteotomy. A higher percentage of patients who underwent osteotomy medicated with 7.5mg meloxicam needed rescue medication as compared to those who did not require osteotomy (P<0.05). There was a similar mouth opening at suture removal compared with preoperative values for both doses (P>0.05). There were no significant differences concerning swelling observed on the 2nd or 7th postoperative days in comparison with baseline (P>0.05) between the two doses. Pain, trismus and swelling after lower third molar removal not requiring osteotomy can be successfully controlled by a dose regimen of 7.5mg meloxicam once daily. For more aggressive extractions 15 mg meloxicam is advisable.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Tiazinas/administração & dosagem , Tiazóis/administração & dosagem , Extração Dentária , Administração Oral , Adulto , Análise de Variância , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Edema/prevenção & controle , Feminino , Humanos , Masculino , Meloxicam , Osteotomia , Amplitude de Movimento Articular , Estatísticas não Paramétricas , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Trismo/prevenção & controle
4.
Int J Oral Maxillofac Surg ; 46(5): 621-627, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28161136

RESUMO

Postoperative pain and inflammation after oral surgery is mostly managed using non-steroidal anti-inflammatory drugs (NSAIDs). However, opioids combined with NSAIDs may improve pain management in patients, especially after traumatic oral surgery. Few studies have compared NSAIDs with and without opioid use after oral and maxillofacial surgery. This randomized, double-blind, cross-over study compared the clinical efficacy of either diclofenac (50mg) and codeine (50mg) or diclofenac alone (50mg) for the management of postoperative pain after invasive third molar surgery. Volunteers (n=46) who were scheduled to undergo the removal of symmetrically positioned lower third molars in two separate appointments were included. They reported significantly less postoperative pain at various time points within 24h after surgery and also consumed significantly less rescue medication (paracetamol (acetaminophen)) throughout the study when they took diclofenac combined with codeine than when they took only diclofenac. In conclusion, oral diclofenac with codeine was more effective for managing postoperative pain than diclofenac without codeine. It was expected that patients taking two pain medications after surgery would generally have less pain than when taking only one of the two medications. The prospective cross-over design of the present work makes this study distinct from many others.


Assuntos
Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Codeína/uso terapêutico , Diclofenaco/uso terapêutico , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dente Impactado/cirurgia , Administração Oral , Analgésicos Opioides/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Codeína/administração & dosagem , Estudos Cross-Over , Diclofenaco/administração & dosagem , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Manejo da Dor , Medição da Dor , Extração Dentária , Resultado do Tratamento , Adulto Jovem
5.
J Dent Res ; 94(9 Suppl): 166S-73S, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26202994

RESUMO

This double-blind crossover randomized clinical trial compared the efficacy of 2 concentrations of articaine, 2% (A2) and 4% (A4), with 1:200,000 epinephrine, for lower third molar removal. During 2 separate appointments with either A2 or A4, both similarly positioned lower third molars in 46 volunteers were extracted. The following were evaluated: onset and duration of anesthetic action on soft tissues, intraoperative bleeding, hemodynamic parameters, postoperative analgesia, and mouth opening and wound healing during the 7th postoperative day, along with the incidence, type, and severity of adverse reactions. Nearly identical volumes of both anesthetic solutions were used for each appointment: 3.4 ± 0.9 mL ≈ 68 mg of articaine (A2) and 3.3 ± 0.8 mL ≈ 132 mg of articaine (A4). Statistical analysis indicated no differences in onset or duration of anesthetic action on soft tissues or duration of postoperative analgesia evoked by A2 and A4 anesthetic solutions (P > 0.05). The surgeon's rating of intraoperative bleeding was considered minimal throughout all surgery with both anesthetic solutions. While transient changes in blood pressure, heart rate, and oxygen saturation were observed, these factors were clinically insignificant and were uninfluenced by articaine concentration (P > 0.05). No systemic or local adverse reactions were observed in the preoperative and postoperative periods due to A2 or A4, but 1 case of bilateral paresthesia was observed. There were no significant differences between preoperative and postoperative (7th day) values of mouth opening and wound healing whether volunteers received A2 or A4 (P > 0.05). In conclusion, both A2 and A4, administered in equal volumes, were effective and safe during lower third molar surgery, and no significant differences were found between their efficacy and safety (ClinicalTrials.gov NCT02457325).


Assuntos
Anestésicos Locais/administração & dosagem , Carticaína/administração & dosagem , Dente Serotino/cirurgia , Extração Dentária/métodos , Adolescente , Adulto , Anestesia Dentária/métodos , Anestésicos Locais/efeitos adversos , Anti-Inflamatórios não Esteroides/uso terapêutico , Perda Sanguínea Cirúrgica , Pressão Sanguínea/fisiologia , Carticaína/efeitos adversos , Estudos Cross-Over , Método Duplo-Cego , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Humanos , Masculino , Mandíbula/cirurgia , Bloqueio Nervoso/métodos , Oxigênio/sangue , Dor Pós-Operatória/prevenção & controle , Piroxicam/uso terapêutico , Segurança , Dente Impactado/cirurgia , Resultado do Tratamento , Cicatrização/fisiologia , Adulto Jovem
6.
Int J Oral Maxillofac Surg ; 40(3): 292-7, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21144709

RESUMO

In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p>0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p>0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p>0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Piroxicam/administração & dosagem , Extração Dentária , Acetaminofen/uso terapêutico , Administração Oral , Administração Sublingual , Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Estudos Cross-Over , Edema/tratamento farmacológico , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/cirurgia , Osteotomia , Complicações Pós-Operatórias/tratamento farmacológico , Amplitude de Movimento Articular/fisiologia , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Trismo/tratamento farmacológico , Adulto Jovem
7.
Braz. j. med. biol. res ; 40(8): 1133-1140, Aug. 2007. tab, graf
Artigo em Inglês | LILACS | ID: lil-456809

RESUMO

We compared the clinical efficacy of orally administered valdecoxib and piroxicam for the prevention of pain, trismus and swelling after removal of horizontally and totally intrabony impacted lower third molars. Twenty-five patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Valdecoxib (40 mg) or piroxicam (20 mg) was administered in a double-blind, randomized and crossed manner for 4 days after the surgical procedures. Objective and subjective parameters were recorded for comparison of postoperative courses. Both agents were effective for postoperative pain relief (N = 19). There was a similar mouth opening at suture removal compared with the preoperative values (86.14 ± 4.36 and 93.12 ± 3.70 percent of the initial measure for valdecoxib and piroxicam, respectively; ANOVA). There was no significant difference regarding the total amount of rescue medication taken by the patients treated with valdecoxib or piroxicam (173.08 ± 91.21 and 461.54 ± 199.85 mg, respectively; Wilcoxon test). There were no significant differences concerning the swelling observed on the second postoperative day compared to baseline measures (6.15 ± 1.84 and 8.46 ± 2.04 mm for valdecoxib and piroxicam, respectively; ANOVA) or on the seventh postoperative day (1.69 ± 1.61 and 2.23 ± 2.09 mm for valdecoxib and piroxicam, respectively; ANOVA). The cyclooxygenase-2 selective inhibitor valdecoxib is as effective as the non-selective cyclooxygenase inhibitor piroxicam for pain, trismus and swelling control after removal of horizontally and totally intrabony impacted lower third molars.


Assuntos
Adulto , Feminino , Humanos , Masculino , Inibidores de Ciclo-Oxigenase/uso terapêutico , Edema/tratamento farmacológico , Isoxazóis/uso terapêutico , Dente Serotino/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Piroxicam/uso terapêutico , Sulfonamidas/uso terapêutico , Trismo/tratamento farmacológico , Método Duplo-Cego , Extração Dentária , Resultado do Tratamento
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