Associação de dexametasona e loxoprofeno na analgesia preemptiva em remoção de terceiros molares.
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Data
2020-09-17
Autores
Ferraz, Luiza Grando [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A administração preemptiva de medicamentos com propriedades anti-inflamatórias, em casos de extração de terceiros molares inferiores, leva à redução dos sinais e sintomas da inflamação como edema, hiperemia, dor e trismo no pós-operatório. Neste trabalho é apresentado um estudo randomizado, triplo cego, em que o objetivo foi avaliar o efeito da analgesia preemptiva na extração de terceiros molares inferiores, utilizando três protocolos medicamentosos: dexametasona, loxoprofeno e a combinação de ambos, através da percepção da dor, do número de analgésicos de resgate consumidos, e da mensuração do edema e trismo pós-operatório. Foram tratados quarenta pacientes jovens e saudáveis com indicação para extração de terceiro molar inferior que não estivessem na posição C e classe III de Pell & Gregory. Estes foram divididos dentro de três grupos: DEX (dexametasona 8mg), DEX+LOX (dexametasona 8mg + loxoprofeno 60mg) e LOX (loxoprofeno 60mg). Os resultados de avaliação da dor através da Escala Visual Analógica (EVA) mostraram que o loxoprofeno utilizado sozinho apresentou EVA maior ou igual a 5 em mais de 70% dos pacientes nas primeiras 6 horas, entretanto não houve diferença estatisticamente significante entre os grupos (P>0.05). Na análise do consumo de analgésicos de resgate, não houve diferença estatisticamente significante entre os grupos (P=0.181). Para a variável edema, o grupo DEX+LOX apresentou os menores valores numéricos, porém não houve diferença estatisticamente significante entre os grupos (P>0.05). No caso do trismo, o grupo DEX apresentou o menor nível em 7 dias (P<0.001). Portanto, a associação de dexametasona com loxoprofeno não apresentou os resultados esperados, levando a maiores dúvidas quanto ao mecanismo de ação do loxoprofeno, que é um anti-inflamatório não esteroidal. Mesmo quando utilizado sozinho, apresentou menor ação anti-inflamatória do que os outros grupos aqui analisados.
Preemptive administration of drugs with anti-inflammatory properties, in cases of extraction of lower third molars, leads to reduction of signs and symptoms of postoperative inflammation, like edema, hyperemia, pain and trismus. The aim of this randomized, triple blind, trial was to evaluate the efficacy of preemptive analgesia in lower third molar extraction in the use of the three drug protocols: dexamethasone, loxoprofen and the combination of both, through the perception of pain, number of rescue analgesics consumed, postoperative edema and trismus. Forty healthy young patients with indication for lower third molar extraction who were not in position C and class III of Pell & Gregory were selected. These were divided into three groups: DEX (8mg dexamethasone), DEX+LOX (8mg dexamethasone + 60mg loxoprofen) and LOX (60mg loxoprofen). The results of pain assessment by visual analogic scale (VAS) showed that loxoprofen administration alone presented VAS greater than or equal to 5 in more than 70% of patients in the first 6 hours, however there was no statistically significant difference among groups (P>0.05). In the analgesic rescue analysis, there was no statistically significant difference among groups (P=0.181). For the edema variable, group DEX+LOX had the lowest numerical values, but there was no statistically significant difference among groups (P>0.05). For the results of trismus, the result was different from expected, with DEX presenting the lowest at 7 days (P<0.001). Thus, the association of dexamethasone with loxoprofen, used for preemptive purposes, did not present the expected results, leading to greater doubts regarding the mechanism of action of loxoprofen, which was previously described as non-steroidal anti-inflammatory. Thus, even when used alone, it presented a lower anti-inflammatory action than the other groups assessed here.
Preemptive administration of drugs with anti-inflammatory properties, in cases of extraction of lower third molars, leads to reduction of signs and symptoms of postoperative inflammation, like edema, hyperemia, pain and trismus. The aim of this randomized, triple blind, trial was to evaluate the efficacy of preemptive analgesia in lower third molar extraction in the use of the three drug protocols: dexamethasone, loxoprofen and the combination of both, through the perception of pain, number of rescue analgesics consumed, postoperative edema and trismus. Forty healthy young patients with indication for lower third molar extraction who were not in position C and class III of Pell & Gregory were selected. These were divided into three groups: DEX (8mg dexamethasone), DEX+LOX (8mg dexamethasone + 60mg loxoprofen) and LOX (60mg loxoprofen). The results of pain assessment by visual analogic scale (VAS) showed that loxoprofen administration alone presented VAS greater than or equal to 5 in more than 70% of patients in the first 6 hours, however there was no statistically significant difference among groups (P>0.05). In the analgesic rescue analysis, there was no statistically significant difference among groups (P=0.181). For the edema variable, group DEX+LOX had the lowest numerical values, but there was no statistically significant difference among groups (P>0.05). For the results of trismus, the result was different from expected, with DEX presenting the lowest at 7 days (P<0.001). Thus, the association of dexamethasone with loxoprofen, used for preemptive purposes, did not present the expected results, leading to greater doubts regarding the mechanism of action of loxoprofen, which was previously described as non-steroidal anti-inflammatory. Thus, even when used alone, it presented a lower anti-inflammatory action than the other groups assessed here.
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Palavras-chave
Dente serotino, Edema, Analgesia, Molar, Third