Efficacy of NSAID (Lornoxicam) After Impacted Third-Molar Surgery With/Without Conscious Sedation: A Double-Blind Randomized Clinical Study

Ozkan Ozgul,Selahattin Or

doi:10.12691/ijdsr-6-1-1

Abstract

Aim: Pain and swelling following surgery for impacted third molars can be controlled by various methods. This study compared the analgesic and anti-inflammatory efficacy and tolerability of lornoxicam, aspirin and a placebo with and without conscious sedation in impacted mandibular third-molar surgery. Materials and Methods: 60 patients undergoing third-molar surgery were divided into 2 groups of conscious sedation and routine local anesthesia (n=30). Both groups were divided into three subgroups (n=10) that received either Lornoxicam, aspirin, or a placebo postoperatively. Results: In both the conscious sedation and local anesthesia groups, swelling reduction was significantly greater with Lornoxicam compared to aspirin and placebo (pConclusion: Conscious sedation resulted less pain and swelling. Moreover, Lornoxicam was found to be an effective analgesic and anti-inflammatory agent for use in conjunction with oral surgery.

Highlights

Patients undergoing oral surgery may experience anxiety and discomfort that makes treatment difficult for the patient as well as the doctor and can extend the duration of surgery. [1,2] Impacted third molar surgery, the most common type of oral surgery procedure, can cause severe inflammation and pain postoperatively. [3,4]In order to secure a more comfortable operative procedure, instead of local anesthesia, the patient may be provided with conscious sedation by one of several methods, including ‘inhalation conscious sedation’, ‘intramuscular conscious sedation’ and ‘intravenous conscious sedation’
The drug has a half-life of 3-5 hours and poor solubility in acidic conditions. [9,10] There are several studies investigating the effects of conscious sedation and NSAİ on postoperative pain and swelling after third molar surgery
Postoperative complications such as pain, swelling, trismus and bleeding vary depending upon the medical condition and age of the patient. [17,18,19,20] In order to prevent differences arising from such factors and ensure standardization, the population of this study was comprised of healthy, young individuals who had fully completed their growth and who had impacted teeth of similar severity

Summary

Introduction

Patients undergoing oral surgery may experience anxiety and discomfort that makes treatment difficult for the patient as well as the doctor and can extend the duration of surgery. [1,2] Impacted third molar surgery, the most common type of oral surgery procedure, can cause severe inflammation and pain postoperatively. [3,4]In order to secure a more comfortable operative procedure, instead of local anesthesia, the patient may be provided with conscious sedation by one of several methods, including ‘inhalation conscious sedation’, ‘intramuscular conscious sedation’ and ‘intravenous conscious sedation’. The standard technique used in dentistry and oral surgery is intravenous conscious sedation with midazolam, a benzodiazepine with a short half-life of 2-3 hours. In order to control the amount and intensity of edema, pain and trismus occurring after surgical extraction and help patients maintain their social activities, various pharmacological and/or extraction methods have been used. These include non-steroid anti-inflammatory drugs (NSAIDs), laser treatment, steroids and ultrasound. [9,10] There are several studies investigating the effects of conscious sedation and NSAİ on postoperative pain and swelling after third molar surgery. There is no study of lornoxicam and conscious sedation when used together in eliminating the pain and swelling following the third molar surgery whether they would result in synergistically or not

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Discussion

Conclusion