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Topikal ve sistemik flurbiprofenin gömülü üçüncü molar cerrahisi sonrası ağrı ve ödem üzerine etkilerinin ve gastrointestinal yan etkilerinin karşılaştırılması

Year 2020, Volume: 45 Issue: 1, 141 - 147, 31.03.2020
https://doi.org/10.17826/cumj.631371

Abstract

Amaç: Bu çalışmanın amacı, gömülü üçüncü molar diş cerrahisinden sonra sistemik ve topikal nonsteroid antiinflamatuar ilaçların postoperatif ağrı ve ödem üzerine etkileri ve ayrıca gastrointestinal yan etkilerin değerlendirilmesidir.
Gereç ve Yöntem: Bu klinik çalışmaya, benzer pozisyonda mandibular gömülü üçüncü molar dişe sahip 100 sağlıklı hasta dahil edilmiştir. Operasyon sonrasında hastalar iki gruba ayrıldı, bir gruba Flurbiprofen tablet uygulanırken, diğer gruba da Flurbiprofen 0.25% Oral spray uygulandı. Ağrı, postoperatif olarak Vizüel Ağrı Skalası (VAS) ile değerlendirildi. Ödem ölçümü preoperatif ve postoperatif 2. ve 7. günlerde yapıldı. Mide bulantısı, mide yanması, dispepsi, kusma ve ishal gibi nosteroid anti-inflamatuar ilaç kullanımına bağlı gastrointestinal yan etkiler hastalardan alınan bilgilere göre kaydedildi.
Bulgular: Gruplar arasında 6, 8, 12, 24 ve 48. saatler arasında Vizüel Ağrı Skalası düzeyleri açısından istatistiksel olarak anlamlı fark vardı. Sistemik nonsteroidal antienflamatuar ilaç grubunun 2. gündeki ödem ölçümleri lokal topikal nonsteroidal antiinflamatuvar ilaç grubuna göre istatistiksel olarak daha düşük bulundu.
Sonuç: Topikal kullanılan nonsteroid anti-inflamatuar ilaçların ağrı ve ödem üzerine etkinlikleri sistemik nonsteroid anti-inflamatuar ilaçlara göre daha düşük olmasına rağmen, daha az gastrointestinal yan etkiye sahip olduğu için tercih edilebilir.

References

  • 1. Santosh P. Impacted mandibular third molars: review of literature and a proposal of a combined clinical and radiological classification. Ann Med Health Sci Res. 2015;5(4):229–234.
  • 2. Gorecki P, Rainsford K, Taneja P, Bulsara Y, Pearson D, Saund D, et al. Submucosal diclofenac for acute postoperative pain in third molar surgery: a randomized, controlled clinical trial. J Dent Res. 2018;97(4):381–387.
  • 3. Landucci A, Wosny A, Uetanabaro L, Moro A, Araujo M. Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery. Int J Oral Maxillofac Surg. 2016;45(3):392–398.
  • 4. Kim JC, Choi SS, Wang SJ, Kim SG. Minor complications after mandibular third molar surgery: type, incidence, and possible prevention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(2):e4–e11.
  • 5. Sortino F, Cicciù M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan). 2011;8(4):162-171.
  • 6. Rashid H, Hussain A, Sheikh AH, Azam K, Malik S, Amin M. Measure of frequency of alveolar osteitis using two different methods of osteotomy ın mandibular third molar ımpactions: a double-blind randomized clinical trial. J Ayub Med Coll Abbottabad. 2018;30(1):103-106.
  • 7. Vegas-Bustamante E, Micó-Llorens J, Gargallo-Albiol J, Satorres-Nieto M, Berini-Aytés L, Gay-Escoda C. Efficacy of methylprednisolone injected into the masseter muscle following the surgical extraction of impacted lower third molars. Int J Oral Maxillofac Surg. 2008;37(3):260-3.
  • 8. Litkowski LJ, Christensen SE, Adamson DN, Van Dyke T, Han SH, Newman KB. Analgesic efficacy and tolerability of oxycodone 5 mg/ibuprofen 400 mg compared with those of oxycodone 5 mg/acetaminophen 325 mg and hydrocodone 75 mg/acetaminophen 500 mg in patients with moderate to severe postoperative pain: a randomized, double-blind, placebo-controlled, single dose, parallel-group study in a dental pain model. Clin Ther. 2005;27(4):418-29.
  • 9. Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37(3):264-8.
  • 10. Van den Bekerom MP, Sjer A, Somford MP, Bulstra GH, Struijs PAA, Kerkhoffs GMMJ. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surg Sports Traumatol Arthrosc. 2015;23:2390–2399.
  • 11. Argoff CE. Topical analgesics in the management of acute and chronic pain. Mayo Clin Proc. 2013;88:195–205.
  • 12. Bjørnsson GA, Haanaes HR, Skoglund LA. Ketoprofen 75 mg qid versus acetaminophen 1000 mg qid for 3 days on swelling, pain, and other postoperative events after third- molar surgery. J Clin Pharmacol. 2003;43:305–14.
  • 13. Akinbade AO, Ndukwe KC, Owotade FJ. Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: A double blind randomized controlled trial. Niger J Clin Pract. 2019;22(6):796-800.
  • 14. Seymour RA, Hawkesford JE, Weldon M, Brewster D. An evaluation of different ibuprofen preparations in postop- erative pain after third molar surgery. Br J Clin Pharmacol. 1991;31:83-87.
  • 15. Parry M, Watt-Watson J, Hodnett E, Tranmer J, Dennis CL, Brooks D. Pain experiences of men and women after coronary artery bypass graft surgery. J Cardiovas Nurs. 2010;25:e9e15.
  • 16. Kaplan V, Eroglu CN. Comparison of the Effects of Daily Single-Dose Use of Flurbiprofen, Diclofenac Sodium, and Tenoxicam on Postoperative Pain, Swelling, and Trismus: A Randomized Double-Blind Study. J Oral Maxillofac Surg. 2016;74(10):1946.e1-6.
  • 17. Isola G, Alibrandi A, Pedullà E, Grassia V, Ferlito S, Perillo L, Rapisarda E. Analysis of the Effectiveness of Lornoxicam and Flurbiprofen on Management of Pain and Sequelae Following Third Molar Surgery: A Randomized, Controlled, Clinical Trial. J Clin Med. 2019;8(3). pii: E325.
  • 18. Tiso RL, Tong-Ngork S, Fredlund KL. Oral versus topical ibuprofen for chronic knee pain: a prospective randomized pilot study. Pain Physician. 2010;13:457–67.
  • 19. Underwood M, Ashby D, CrossP, Hennessy E, Letley L, Martin J, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ. 2008; 336: 138–42.
  • 20. Whitefield M, O’Kane CJ, Anderson S. Comparative efficacy of a proprietary topical ibuprofen gel and oral ibuprofen in acute soft tissue injuries: a randomized, double-blind study. J Clin Pharm Ther. 2002;27:409–17.
  • 21. Klinge SA, Sawyer GA. Effectiveness and safety of topical versus oral nonsteroidal anti-inflammatory drugs: a comprehensive review. Physic Sport Med. 2013;41:64-74.
  • 22. Lin J, Zhang W, Jones A, Doherty M. Efficacy of topical non-steroidal antiinflammatory drugs in the treatment of osteoarthritis: meta-analysis of randomised controlled trials. BMJ. 2004;329:324.
  • 23. Machen J, Whitefield M. Efficacy of a proprietary ibuprofen gel in soft tissue injuries: a randomised, double-blind, placebo-controlled study. Int J Clin Pract. 2002;56:102–6.

Efficiency of topical and systemic flurbiprofen on pain and edema after impacted third molar surgery and comparison of gastrointestinal adverse effects

Year 2020, Volume: 45 Issue: 1, 141 - 147, 31.03.2020
https://doi.org/10.17826/cumj.631371

Abstract

Purpose: The aim of this study was to evaluate the effects of systemic and topical nonsteroidal anti-inflammatory agents on postoperative pain and edema and also gastrointestinal side effects after impacted third molar surgery.
Materials and Methods: In this clinical study, 100 healthy patients with mandibular impacted third molar teeth in a similar position were included. After the operation, patients were divided into two groups, one group received Flurbiprofen tablets and the other group received Flurbiprofen 0.25% Oral spray. The pain was assessed postoperatively by Visual Analog Scale (VAS). The edema evaluation was measured on preoperative and postoperative 2nd and 7th days. Gastrointestinal adverse effects related to the use of nonsteroidal anti-inflammatory drug such as nausea, heartburn, dyspepsia, vomiting, and diarrhea were recorded according to information received from patients.
Results: There was a statistically significant difference between the groups with regard to Visual Analog Scale levels at 6th, 8th, 12th, 24th, and 48th hours. 2nd-day edema measurements of the systemic nonsteroidal anti-inflammatory drug group were found to be statistically lower than the local-topical nonsteroidal anti-inflammatory drug group.
Conclusion: Although the efficacy of topical nonsteroidal anti-inflammatory drugs on pain and edema is lower than systemic nonsteroidal anti-inflammatory drugs, it may be preferred because it has less gastrointestinal side effects.

References

  • 1. Santosh P. Impacted mandibular third molars: review of literature and a proposal of a combined clinical and radiological classification. Ann Med Health Sci Res. 2015;5(4):229–234.
  • 2. Gorecki P, Rainsford K, Taneja P, Bulsara Y, Pearson D, Saund D, et al. Submucosal diclofenac for acute postoperative pain in third molar surgery: a randomized, controlled clinical trial. J Dent Res. 2018;97(4):381–387.
  • 3. Landucci A, Wosny A, Uetanabaro L, Moro A, Araujo M. Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery. Int J Oral Maxillofac Surg. 2016;45(3):392–398.
  • 4. Kim JC, Choi SS, Wang SJ, Kim SG. Minor complications after mandibular third molar surgery: type, incidence, and possible prevention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(2):e4–e11.
  • 5. Sortino F, Cicciù M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan). 2011;8(4):162-171.
  • 6. Rashid H, Hussain A, Sheikh AH, Azam K, Malik S, Amin M. Measure of frequency of alveolar osteitis using two different methods of osteotomy ın mandibular third molar ımpactions: a double-blind randomized clinical trial. J Ayub Med Coll Abbottabad. 2018;30(1):103-106.
  • 7. Vegas-Bustamante E, Micó-Llorens J, Gargallo-Albiol J, Satorres-Nieto M, Berini-Aytés L, Gay-Escoda C. Efficacy of methylprednisolone injected into the masseter muscle following the surgical extraction of impacted lower third molars. Int J Oral Maxillofac Surg. 2008;37(3):260-3.
  • 8. Litkowski LJ, Christensen SE, Adamson DN, Van Dyke T, Han SH, Newman KB. Analgesic efficacy and tolerability of oxycodone 5 mg/ibuprofen 400 mg compared with those of oxycodone 5 mg/acetaminophen 325 mg and hydrocodone 75 mg/acetaminophen 500 mg in patients with moderate to severe postoperative pain: a randomized, double-blind, placebo-controlled, single dose, parallel-group study in a dental pain model. Clin Ther. 2005;27(4):418-29.
  • 9. Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37(3):264-8.
  • 10. Van den Bekerom MP, Sjer A, Somford MP, Bulstra GH, Struijs PAA, Kerkhoffs GMMJ. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surg Sports Traumatol Arthrosc. 2015;23:2390–2399.
  • 11. Argoff CE. Topical analgesics in the management of acute and chronic pain. Mayo Clin Proc. 2013;88:195–205.
  • 12. Bjørnsson GA, Haanaes HR, Skoglund LA. Ketoprofen 75 mg qid versus acetaminophen 1000 mg qid for 3 days on swelling, pain, and other postoperative events after third- molar surgery. J Clin Pharmacol. 2003;43:305–14.
  • 13. Akinbade AO, Ndukwe KC, Owotade FJ. Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: A double blind randomized controlled trial. Niger J Clin Pract. 2019;22(6):796-800.
  • 14. Seymour RA, Hawkesford JE, Weldon M, Brewster D. An evaluation of different ibuprofen preparations in postop- erative pain after third molar surgery. Br J Clin Pharmacol. 1991;31:83-87.
  • 15. Parry M, Watt-Watson J, Hodnett E, Tranmer J, Dennis CL, Brooks D. Pain experiences of men and women after coronary artery bypass graft surgery. J Cardiovas Nurs. 2010;25:e9e15.
  • 16. Kaplan V, Eroglu CN. Comparison of the Effects of Daily Single-Dose Use of Flurbiprofen, Diclofenac Sodium, and Tenoxicam on Postoperative Pain, Swelling, and Trismus: A Randomized Double-Blind Study. J Oral Maxillofac Surg. 2016;74(10):1946.e1-6.
  • 17. Isola G, Alibrandi A, Pedullà E, Grassia V, Ferlito S, Perillo L, Rapisarda E. Analysis of the Effectiveness of Lornoxicam and Flurbiprofen on Management of Pain and Sequelae Following Third Molar Surgery: A Randomized, Controlled, Clinical Trial. J Clin Med. 2019;8(3). pii: E325.
  • 18. Tiso RL, Tong-Ngork S, Fredlund KL. Oral versus topical ibuprofen for chronic knee pain: a prospective randomized pilot study. Pain Physician. 2010;13:457–67.
  • 19. Underwood M, Ashby D, CrossP, Hennessy E, Letley L, Martin J, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ. 2008; 336: 138–42.
  • 20. Whitefield M, O’Kane CJ, Anderson S. Comparative efficacy of a proprietary topical ibuprofen gel and oral ibuprofen in acute soft tissue injuries: a randomized, double-blind study. J Clin Pharm Ther. 2002;27:409–17.
  • 21. Klinge SA, Sawyer GA. Effectiveness and safety of topical versus oral nonsteroidal anti-inflammatory drugs: a comprehensive review. Physic Sport Med. 2013;41:64-74.
  • 22. Lin J, Zhang W, Jones A, Doherty M. Efficacy of topical non-steroidal antiinflammatory drugs in the treatment of osteoarthritis: meta-analysis of randomised controlled trials. BMJ. 2004;329:324.
  • 23. Machen J, Whitefield M. Efficacy of a proprietary ibuprofen gel in soft tissue injuries: a randomised, double-blind, placebo-controlled study. Int J Clin Pract. 2002;56:102–6.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Ahmet Taylan Çebi 0000-0001-9083-7215

Publication Date March 31, 2020
Acceptance Date November 27, 2019
Published in Issue Year 2020 Volume: 45 Issue: 1

Cite

MLA Çebi, Ahmet Taylan. “Efficiency of Topical and Systemic Flurbiprofen on Pain and Edema After Impacted Third Molar Surgery and Comparison of Gastrointestinal Adverse Effects”. Cukurova Medical Journal, vol. 45, no. 1, 2020, pp. 141-7, doi:10.17826/cumj.631371.