A relatively new class of orally administered analgesics, the nonsteroidal anti-inflammatory drugs, has been shown to be particularly effective for the relief of pain which follows the removal of impacted third molar teeth. Nonsteroidal anti- inflammatory drugs administered following the onset of postsurgical pain have been shown to be as effective as narcotic- containing analgesics administered postoperatively. Nonsteroidal anti-inflammatory drugs administered prior to surgery have been shown to have significantly greater analgesic activity than narcotic-containing analgesics given either preoperatively or postoperatively. However, the administration of nonsteroidal anti-inflammatory drugs preoperatively has been reported to result in increased incidence of postoperative alveolar osteitis. In addition, most clinicians are reluctant to administer any medication orally prior to surgical procedures which will be performed with either sedation or general anesthesia. This study will compare the analgesic efficacies of two therapeutic regimens of a nonsteroidal anti-inflammatory drug, flurbiprofen 50mg, administered to human subjects undergoing surgery for removal of impacted third molar teeth. Preoperative and postoperative drug administration will be compared, using a within-subject crossover experimental design. Pain intensity will be assessed hourly using category rating scales and visual analog scales. Side effect data will also be collected hourly. Postoperative healing will be assessed on the third and seventh postoperative days. If immediate postoperative administration of a nonsteroidal anti-inflammatory drug is as effective as preoperative administration, and also have reduced side-effect liability and reduced incidence of alveolar osteitis, this therapeutic regimen may minimize the necessity for use of narcotic-containing analgesics.
| Sisk, A L; Grover, B J (1990) A comparison of preoperative and postoperative naproxen sodium for suppression of postoperative pain. J Oral Maxillofac Surg 48:674-8 |
