구강 수술 후 투여 시기에 따른 진통 요법의 효과

Abstract

Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, many studies on efficacy of preemptive analgesia have been processed in different ways about various drugs, administration methods and times especially for various operations. But the value of preemptive analgesia is still controversial. The authors performed a clinical study on analgesic effect of an NSAID according to administration time for oral surgical pain and present the more effective pain treatment after surgery with literature review. Methods: Using a randomized and double blind test design, this study compared the analgesic effect of Talniflumate 370 mg as an NSAID to healthy 85 patients underwent the surgical removal of impacted mandibular third molar teeth. This drug was administered first 1 hour preoperatively, 1 hour postoperatively, or no scheduled administration in pre- or postsurgery. And pain intensities and times from the end of surgery were assessed postoperatively whenever the patients demanded additional drugs when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) for 48 hours. Results: The sex distribution, the age of the patients, and the time required for surgeries in three groups were similar statistically. The average first time for demanding additional drug after surgery was significantly prolonged in post-treatment group(277.2 minutes) compared to pre-treatment(158.4 minutes) and no treatment group(196.5 minutes). The average second time for demanding additional drug was not different significantly among the 3 groups. No statistically significant difference was found among the average pain intensities at each time for demanding additional drug in 3 groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administered preoperatively in present practices have weak effect for postperative pain, thus the authors recommend that scheduled postoperative analgesics are adequate without preoperative use of analgesics.