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. 1996 Summer;43(3):92–96.

Effectiveness of preoperative analgesics on postoperative dental pain: a study.

M Zacharias 1, K M Hunter 1, A B Baker 1
PMCID: PMC2148768  PMID: 10323113

Abstract

Patients undergoing extractions of third molar teeth under general anesthesia were given a placebo, diclofenac (a nonsteroidal anti-inflammatory drug) 100 mg, or methadone (an opiate) 10 mg 60 to 90 min prior to surgery, and their pain scores and postoperative medication requirements were measured for 3 days. All patients received local anesthetic blocks and analgesic drugs during the perioperative period. There were no significant differences between the three groups in the pain scores and medication requirements during the period of study. It was concluded that preoperative use of nonsteroidal anti-inflammatory drugs and opiates may not offer a preemptive analgesic effect in patients who have had adequate analgesia during the surgery. Continued use of analgesic drugs during the postoperative period is perhaps more useful for this purpose. There appears to be a higher incidence of vomiting following opiates (methadone), precluding its clinical use in day-care patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cousins M. J. John J. Bonica distinguished lecture. Acute pain and the injury response: immediate and prolonged effects. Reg Anesth. 1989 Jul-Aug;14(4):162–179. [PubMed] [Google Scholar]
  2. Dahl J. B., Hansen B. L., Hjortsø N. C., Erichsen C. J., Møiniche S., Kehlet H. Influence of timing on the effect of continuous extradural analgesia with bupivacaine and morphine after major abdominal surgery. Br J Anaesth. 1992 Jul;69(1):4–8. doi: 10.1093/bja/69.1.4. [DOI] [PubMed] [Google Scholar]
  3. Dahl J. B., Kehlet H. Non-steroidal anti-inflammatory drugs: rationale for use in severe postoperative pain. Br J Anaesth. 1991 Jun;66(6):703–712. doi: 10.1093/bja/66.6.703. [DOI] [PubMed] [Google Scholar]
  4. Dahl J. B., Kehlet H. The value of pre-emptive analgesia in the treatment of postoperative pain. Br J Anaesth. 1993 Apr;70(4):434–439. doi: 10.1093/bja/70.4.434. [DOI] [PubMed] [Google Scholar]
  5. Dierking G. W., Dahl J. B., Kanstrup J., Dahl A., Kehlet H. Effect of pre- vs postoperative inguinal field block on postoperative pain after herniorrhaphy. Br J Anaesth. 1992 Apr;68(4):344–348. doi: 10.1093/bja/68.4.344. [DOI] [PubMed] [Google Scholar]
  6. Ejlersen E., Andersen H. B., Eliasen K., Mogensen T. A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain. Anesth Analg. 1992 Apr;74(4):495–498. doi: 10.1213/00000539-199204000-00004. [DOI] [PubMed] [Google Scholar]
  7. ElHag M., Coghlan K., Christmas P., Harvey W., Harris M. The anti-inflammatory effects of dexamethasone and therapeutic ultrasound in oral surgery. Br J Oral Maxillofac Surg. 1985 Feb;23(1):17–23. doi: 10.1016/0266-4356(85)90074-9. [DOI] [PubMed] [Google Scholar]
  8. Hill C. M., Carroll M. J., Giles A. D., Pickvance N. Ibuprofen given pre- and post-operatively for the relief of pain. Int J Oral Maxillofac Surg. 1987 Aug;16(4):420–424. doi: 10.1016/s0901-5027(87)80078-4. [DOI] [PubMed] [Google Scholar]
  9. Jackson D. L., Moore P. A., Hargreaves K. M. Preoperative nonsteroidal anti-inflammatory medication for the prevention of postoperative dental pain. J Am Dent Assoc. 1989 Nov;119(5):641–647. doi: 10.1016/s0002-8177(89)95018-6. [DOI] [PubMed] [Google Scholar]
  10. Katz J., Kavanagh B. P., Sandler A. N., Nierenberg H., Boylan J. F., Friedlander M., Shaw B. F. Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology. 1992 Sep;77(3):439–446. doi: 10.1097/00000542-199209000-00006. [DOI] [PubMed] [Google Scholar]
  11. Katz J. Preop analgesia for postop pain. Lancet. 1993 Jul 10;342(8863):65–66. doi: 10.1016/0140-6736(93)91279-u. [DOI] [PubMed] [Google Scholar]
  12. McQuay H. J., Carroll D., Moore R. A. Postoperative orthopaedic pain--the effect of opiate premedication and local anaesthetic blocks. Pain. 1988 Jun;33(3):291–295. doi: 10.1016/0304-3959(88)90287-4. [DOI] [PubMed] [Google Scholar]
  13. Richmond C. E., Bromley L. M., Woolf C. J. Preoperative morphine pre-empts postoperative pain. Lancet. 1993 Jul 10;342(8863):73–75. doi: 10.1016/0140-6736(93)91284-s. [DOI] [PubMed] [Google Scholar]
  14. Richmond C. E., Bromley L. M., Woolf C. J. Preoperative morphine pre-empts postoperative pain. Lancet. 1993 Jul 10;342(8863):73–75. doi: 10.1016/0140-6736(93)91284-s. [DOI] [PubMed] [Google Scholar]
  15. Tverskoy M., Cozacov C., Ayache M., Bradley E. L., Jr, Kissin I. Postoperative pain after inguinal herniorrhaphy with different types of anesthesia. Anesth Analg. 1990 Jan;70(1):29–35. doi: 10.1213/00000539-199001000-00006. [DOI] [PubMed] [Google Scholar]
  16. Woolf C. J. Recent advances in the pathophysiology of acute pain. Br J Anaesth. 1989 Aug;63(2):139–146. doi: 10.1093/bja/63.2.139. [DOI] [PubMed] [Google Scholar]
  17. Zacharias M., Thyne G. M., Luyk N. H. Local anesthesia during surgery: when is the best time to give it? Anesth Pain Control Dent. 1993 Winter;2(1):9–12. [PubMed] [Google Scholar]

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