Avaliação comparativa da incidência de dor pós-operatória e de parestesia do nervo alveolar inferior utilizando articaína e mepivacaína em cirurgias de terceiros molares inferiores.
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2020-10-09
Autores
Prado, Guilherme Alexandre Silva [UNESP]
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Universidade Estadual Paulista (Unesp)
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Este ensaio clínico randomizado, duplo-cego, cruzado, pareado, teve como objetivo comparar o efeito da mepivacaína e da articaína em doses habituais sobre a intensidade da dor e a necessidade de analgésicos e parestesia após a extração do terceiro molar inferior. A amostra final do estudo foi composta por 20 indivíduos de ambos os gêneros, entre 18 e 35 anos, sem patologias locais ou sistêmicas, possuindo terceiros molares inferiores retidos bilaterais, em posição similar, foram selecionados e submetidos a cirurgias para remoção dos mesmos. Cirurgiões e pacientes foram cegados marcando os cartuchos de articaína e mepivacaína com números (1 e 2, respectivamente) que foi escolhido de forma aleatória, definido pelo Excel 2018. A intensidade da dor pós-operatória (desfecho primário) foi avaliada com uma escala visual analógica (EVA), enquanto a necessidade e o momento da medicação de resgate e a qualidade da anestesia intraoperatória também foram medidos (desfechos secundários) assim como a avaliação da parestesia. A intervenção cirúrgica foi realizada sempre pelo mesmo operador, com a administração de um anestésico em cada lado, Comprimidos de paracetamol 750mg foram prescritos como medicação para analgesia de escape. Resultados: Nenhum dos grupos apresentou parestesia no pós-operatório. Quanto a média de dor encontrada nos grupos foi de 3,08 para articaína e de 3,4 para mepivacaína não havendo diferenças estatísticas entre os grupos. Em relação ao analgésico de resgate de analgésico foi menor no grupo que foi anestesiado com articaína com média de 2,04 e a mepivacaína foi em média de 2,22 embora as diferenças não tenham sido estatisticamente significativas.
This randomized, double-blind, crossed, paired clinical trial aimed to compare the effect of mepivacaine and articaine in usual doses on pain intensity and the need for analgesics and paresthesia after extraction of the third lower molar. The final sample of the study was composed of 20 individuals of both genders, between 18 and 35 years, without local or systemic pathologies, with third lower molars held bilaterally, in a similar position, were selected and submitted to surgeries to remove them. Surgeons and patients were blinded by marking the articaine and mepivacaine cartridges with numbers (1 and 2, respectively) that were chosen randomly, defined by Excel 2018. The intensity of postoperative pain (primary outcome) was evaluated with an analog visual scale (VAS), while the need and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes) as well as the paresthesia assessment. The surgical intervention was always performed by the same operator, with the administration of an anesthetic on each side, Paracetamol 750mg tablets were prescribed as medication for escape analgesia. Results: None of the groups presented postoperative paresthesia. The mean pain found in the groups was 3.08 for articaína and 3.4 for mepivacaine, with no statistical differences between the groups. In relation to analgesic rescue analgesic was lower in the group that was anesthetized with articaine with an average of 2.04 and mepivacaine was on average of 2.22 although the differences were not statistically significant.
This randomized, double-blind, crossed, paired clinical trial aimed to compare the effect of mepivacaine and articaine in usual doses on pain intensity and the need for analgesics and paresthesia after extraction of the third lower molar. The final sample of the study was composed of 20 individuals of both genders, between 18 and 35 years, without local or systemic pathologies, with third lower molars held bilaterally, in a similar position, were selected and submitted to surgeries to remove them. Surgeons and patients were blinded by marking the articaine and mepivacaine cartridges with numbers (1 and 2, respectively) that were chosen randomly, defined by Excel 2018. The intensity of postoperative pain (primary outcome) was evaluated with an analog visual scale (VAS), while the need and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes) as well as the paresthesia assessment. The surgical intervention was always performed by the same operator, with the administration of an anesthetic on each side, Paracetamol 750mg tablets were prescribed as medication for escape analgesia. Results: None of the groups presented postoperative paresthesia. The mean pain found in the groups was 3.08 for articaína and 3.4 for mepivacaine, with no statistical differences between the groups. In relation to analgesic rescue analgesic was lower in the group that was anesthetized with articaine with an average of 2.04 and mepivacaine was on average of 2.22 although the differences were not statistically significant.
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Palavras-chave
Dente serotino, Anestesia local, Carticaína, Mepivacaína, Parestesia, Dor, Pain