Analgesic Efficacy of Prophylactic Gabapentin and Lornoxicam in Preventing Postendodontic Pain

Işık, Berrin; Yaman, Sis Darendeliler; Aktuna, Serkan; Turan, Alparslan

doi:10.1111/pme.12536

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…Figure and Table detail the 133 trials we included in the review, with our categorisation of risks of bias in Fig. . We excluded one duplicate trial , three trials that were unavailable as full text , five trials that did not use a placebo , one trial that used combination therapy and two uncontrolled trials .…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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SummaryWe searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26-9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R 2 = 90%, p < 0.001) by the meta-regression equation: 3.73 + (À0.378 9 control morphine consumption (mg)) + (À0.0023 9 gabapentin dose (mg)) + (À1.917 9 anaesthetic type), where 'anaesthetic type' is '1' for general anaesthesia and '0' for spinal anaesthesia. The type of surgery was not independently associated with gabapentin effect. Gabapentin reduced postoperative pain scores on a 10-point scale at 1 h, 2 h, 6 h, 12 h and 24 h by a mean (95% CI) of: 1.68 (1.35-2.01); 1.21 (0.88-1.55); 1.28 (0.98-1.57); 1.12 (0.91-1.33); and 0.71 (0.56-0.87), respectively, p < 0.001 for all. The risk ratios (95% CI) for postoperative nausea, vomiting, pruritus and sedation with gabapentin were: 0.78 (0.69-0.87), 0.67 (0.59-0.76), 0.64 (0.51-0.80) and 1.18 (1.09-1.28), respectively, p < 0.001 for all. Gabapentin reduced pre-operative anxiety and increased patient satisfaction on a 10-point scale by a mean (95% CI) of 1.52 (0.78-2.26) points and 0.89 (0.22-1.57) points, p < 0.001 and p = 0.01, respectively. All the effects of gabapentin may have been overestimated by statistically significant small study effects.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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“…A study by Işik et al was not included in the present review as it was a nonoral surgery procedure, measured postendodontic pain and evaluated the efficacy of prophylactic gabapentin (600 mg) and lornoxicam (8 mg) in preventing postendodontic pain. 30 They recorded VAS scores at 4, 8, 12 and 24 hours postoperatively and reported that the pain score at 12 hours postoperatively was significantly lower in the gabapentin group than in groups receiving lornoxicam or placebo. 30 A cross-over study by Cheung et al reported greater analgesic efficacy with postoperative administration of pregabalin when compared with preoperative administration following third molar surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…30 They recorded VAS scores at 4, 8, 12 and 24 hours postoperatively and reported that the pain score at 12 hours postoperatively was significantly lower in the gabapentin group than in groups receiving lornoxicam or placebo. 30 A cross-over study by Cheung et al reported greater analgesic efficacy with postoperative administration of pregabalin when compared with preoperative administration following third molar surgeries. 25 Another study not included in this review suggested that perioperative administration of gabapentin given twice daily in patients undergoing head and neck mucosal surgery did not reduce the narcotic usage but there was a reduction in pain scores.…”

Section: Discussionmentioning

confidence: 99%

Pre‐emptive administration of gabapentinoids to reduce postoperative pain and opioid usage following oral and maxillofacial surgical procedures

et al. 2021

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Aim:The objective of this review was to assess the efficiency of pre-emptive gabapentinoid administration on postoperative pain and opioid consumption in patients undergoing oral surgical procedures. Material and Methods:A review of the literature was performed using various indexed databases. A total of six randomized controlled trials (RCTs) were included in the current systematic review which compared postoperative analgesic and/or opioid-sparing effect of gabapentinoids (either alone or in combination with other drugs).Results: Out of the six studies included, four studies showed a statistically significant reduction in pain scores while three studies showed a significant reduction in opioid consumption postoperatively. All studies included reported that adverse effects like nausea and vomiting were higher in the placebo group except for one study, which reported a higher frequency of adverse events in the pregabalin group. The overall risk of bias was low in five studies and moderate in one study. Conclusions:In brief, gabapentinoids when administered pre-emptively in patients undergoing oral surgical procedures reduced postoperative pain and opioid consumption.However, there is a need for further research to come to a consensus regarding the dosage and timing of the pre-emptive gabapentinoids administration. Also, surgery specific research is needed in future studies. K E Y W O R D Saddiction, analgesia, opioids, oral surgery, pain, pre-emptive Clinical RelevanceScientific rationale for study: There is an increasing body of evidence supporting the preoperative use of gabapentinoids for reducing postoperative pain and opioid use. Several systematic reviews and meta-analyses have been published regarding the preoperative use of gabapentinoids in various general surgery procedures whereas there has not been any review regarding their use in oral surgery procedures to our knowledge. This is the motivation behind conducting the current review. Principal findings: Gabapentinoids when given pre-emptively reduce the pain scores and opioid requirements in the postsurgical period with very few adverse effects.

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“…In a preclinical model of pulpitis, administration of pregabalin reduced the medullary release of glutamate and electromyographic activity induced by the application of mustard oil to the tooth pulp [126]. In a clinical trial on patients with endodontic pain, pre-operative administration of 600 mg of gabapentin effectively reduced pain for up to 24 h after treatment [127]. It must be noted that gabapentinoids are most effective in the presence of central sensitization and that they have no anti-inflammatory effect.…”

Section: Gabapentinoidsmentioning

confidence: 99%

Pharmacological Management of Acute Endodontic Pain

Khan

Diogenes

2021

Drugs

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Pain associated with infections of the tooth pulp and periapical tissues is intense and often the most common reason for patients seeking emergency dental care. Effective management of acute dental pain requires a deep understanding of pain mechanisms, which enables accurate diagnosis and definitive treatment. While drugs are only used as an adjunct to definitive dental treatment, a thorough understanding of their mechanism of action and effectiveness enables clinicians to effectively control intra-operative and post-operative pain and prevent persistent pain. This review describes how pain is detected, processed, and perceived. It also provides information on evidence-based strategies on the use of different classes of drugs to effectively manage endodontic pain.

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Analgesic Efficacy of Prophylactic Gabapentin and Lornoxicam in Preventing Postendodontic Pain

Abstract: Based on the obtained data, prophylactic lornoxicam controlled postendodontic treatment pain more effectively than did the placebo drugs, and gabapentin was more effective in controlling the pain than either lornoxicam or the placebo.

Cited by 12 publications

References 32 publications

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

Pre‐emptive administration of gabapentinoids to reduce postoperative pain and opioid usage following oral and maxillofacial surgical procedures

Pharmacological Management of Acute Endodontic Pain

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