Abstract
Background The purpose of this meta-analysis was to assess the clinical efficacy of etoricoxib in comparison with traditional NSAIDs for postoperative pain after third molar surgery. Methods The quality of studies found in PubMed and Google Scholar was evaluated with Cochrane Collaboration's risk of bias tool. Data on total consumption of rescue analgesics, number of patients using rescue analgesics, global assessment of study treatments, and adverse effects were extracted exclusively from high-quality clinical trials. Each meta-analysis was performed with the Review Manager Software 5.3 for Windows. Results The qualitative analysis showed that etoricoxib has better analgesic activity when compared with ibuprofen (2 clinical trials) and diclofenac (1 clinical trial). A similar analgesic efficacy between etoricoxib and nonselective Cox-2 NSAIDs was informed in 3/8 studies (2 compared to ibuprofen and 1 to naproxen sodium). Moreover, the number of patients requiring rescue analgesics in the postoperative period showed a statistical difference in favor of etoricoxib when compared to NSAIDs. Conclusion Etoricoxib significantly reduces the number of patients needing rescue analgesics compared to NSAIDs after third molar surgery.
Highlights
Surgical removal of a mandibular third molar is an important clinical tool to evaluate the analgesic efficacy of new drugs [1, 2]
The most important finding of this review was the lower number of patients who required rescue analgesia in the etoricoxib group when compared with the nonsteroidal anti-inflammatory analgesic drugs (NSAIDs) group
The authors concluded that coxibs have an analgesic effect similar to ibuprofen when used in third molar surgery [10]
Summary
Surgical removal of a mandibular third molar is an important clinical tool to evaluate the analgesic efficacy of new drugs [1, 2]. The selective enzyme cyclooxygenase-2 (COX-2) inhibitor NSAIDs have similar clinical efficacy as nonselective (COX-2) NSAIDs for the management of osteoarthritis [9] and postsurgical dental pain [10] This type of drug has been related to severe adverse effects, such as myocardial infarction [11,12,13], acute kidney injury [14], hepatotoxicity [15], and hypersensitivity [16]. Etoricoxib, a relatively new selective (COX-2) NSAIDs, has been used in several clinical studies to control postoperative complications following a third mandibular molar extraction [17,18,19,20,21,22,23,24], and it has shown similar clinical efficacy than nonselective NSAIDs [20, 21, 24]. Etoricoxib significantly reduces the number of patients needing rescue analgesics compared to NSAIDs after third molar surgery
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