Abstract
The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries. The subjects were divided into five groups (n = 20 teeth/group); subjects received only 8 mg of dexamethasone 1 h before the surgical procedure (DEX group), or in combination with etodolac (DEX + ETO), ketorolac (DEX + KET), ibuprofen (DEX + IBU), loxoprofen (DEX + LOX). Paracetamol 750 mg was provided as the number of rescue analgesics (NRA). Salivary PGE2 expression was measured preoperatively and at 48 h. Edema and Maximum mouth opening (MMO) were measured postoperatively at 48 h and 7 days. A visual analog scale (VAS) was performed postoperatively at 6, 12, 24, 48, 72 h, and 7 days. Salivary expression of PGE2 showed a decrease only for the DEX group. Edema and MMO and NRA consumption showed no significant differences among the groups (P > 0.05). The VAS showed a significantly lower pain perception at 6 h after the surgery for the DEX + ETO and DEX + KET groups (P < 0.05). The combination of DEX and NSAIDS should be considered for preemptive acute postsurgical pain management in third molar surgery. In some drug associations such as dexamethasone 8 mg + NSAIDS (ETO and KET) in the pre-operative time, only a few rescue analgesics are necessary.
Highlights
The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries
Preemptive analgesia consists of managing drugs prior to nociceptive stimulation and is defined as an antinociceptive treatment that prevents the inflammatory response from stimulation of the afferent pathway to the central nervous system
Since there is a lack of consensus and few studies regarding the preemptive combination of steroids and NSAIDs aimed at improving the postoperative pain symptoms after third molar surgery, the purpose of this study is to compare the preemptive use of dexamethasone alone, and the combination of dexamethasone with different NSAIDs, in third molar surgeries
Summary
The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries. Postoperative pain and edema remain significant concerns for patients who undergo third molar removal For this reason, the literature contains several studies about controlling these s ymptoms[1]. Preemptive analgesia consists of managing drugs prior to nociceptive stimulation and is defined as an antinociceptive treatment that prevents the inflammatory response from stimulation of the afferent pathway to the central nervous system This general mechanism is responsible for the amplification of the postoperative pain response[5]. Several authors have demonstrated the efficacy of these drugs, mainly in the control of postoperative edema and trismus (MMO)[6,7,8,9] This effect is achieved because corticosteroids inhibit the Scientific Reports | (2021) 11:24445. The use of corticosteroids is believed to inhibit the initial step in this process[6]
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