Does Sub-Anesthetic Ketamine Provide Postoperative Analgesia for Third Molar Surgery?

Cheung, Johnson; Alashi, Ahmad; Koto, Prosper; Brady, James; Davis, Benjamin R.

doi:10.1016/j.joms.2019.05.009

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…One of the commonest operations done by oral and maxillofacial surgeons around the world is the surgical extraction of an impacted lower third molar. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study

Dutta,

Kumar,

Kumar

et al. 2023

Annals of Maxillofacial Surgery

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Introduction: Disimpaction is one of the most common operations done by oral and maxillofacial surgeons around the world. Ketamine is a well-known general anaesthetic and short-acting intraoperative analgesic. The aim of this study was to measure the efficacy of anaesthesia using combined treatment with local anaesthetic plus a subanaesthetic dose of ketamine and local anaesthetic alone in bilaterally impacted mandibular third molar surgery. Methods and Materials: A total of 24 patients who consented were taken up for a split-mouth study. In the control group, surgical extraction of the impacted lower third molar was done using local anaesthesia (lignocaine 2% with 1:80,000 adrenaline) only, and in the study group, local anaesthesia with ketamine extraction was done using ketamine (0.2 mg/kg) along with local anaesthesia (LA). The time of onset and the duration of anaesthesia intraoperatively were recorded using a digital stopwatch. The depth of anaesthesia was noted on the 10th, 30th and 60th min. After extraction, the post-operative pain on the first, fourth, eighth and 12th hour was evaluated using a Visual Analogue Scale (VAS) score rating of 1–10. The pulse was also noted and compared for any differences in either of the groups. Results: A statistically significant (P < 0.005) difference in result was obtained for the onset, duration, depth and pain score after surgical extraction in both the evaluated groups. The pain index score by the ketamine group was significantly low as compared to the local anaesthesia-only group. Intraoperative onset, duration and depth of anaesthesia obtained had a significant difference. Discussion: Ketamine can be used as a viable option for surgical third molar extractions with reduced discomfort and post-operative pain.

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“…One of the commonest operations done by oral and maxillofacial surgeons around the world is the surgical extraction of an impacted lower third molar. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study

Dutta,

Kumar,

Kumar

et al. 2023

Annals of Maxillofacial Surgery

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The effect of esketamine combined with sufentanil based patient-controlled intravenous analgesia for postoperative pain in patients undergoing third molar surgery and maxillofacial trauma: a randomized clinical trial

Li,

He,

et al. 2024

BMC Oral Health

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Purpose This study aims to investigate the effects of combining esketamine with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) in patients undergoing elective impacted tooth surgery or open reduction and internal fixation. Methods In this single-center, prospective, double-blinded, randomized, parallel-controlled trial, 91 patients were randomly divided into two groups. The experimental group (group ES, n = 46) received a combination of sufentanil 1.5 µg/kg and esketamine 1.0 mg/kg, while the control group (group S, n = 45) received sufentanil 2 µg/kg alone for PCIA after surgery. Primary outcome was assessed using the Visual Analogue Scale (VAS) for patients at rest and during mouth opening at 6 h, 12 h, 24 h, and 48 h post-surgery. Secondary outcomes included the Ramsay Sedation Scale (RSS) scores, the Quality of Recovery-15 (QoR-15) scores, patient satisfaction with analgesia, and the occurrence of adverse events within 48 h post-surgery. The frequency of PCIA button presses and the number of patients requiring rescue analgesia were also recorded. Results The resting VAS scores and the mouth-opening VAS scores at 6 h, 12 h, 24 h, and 48 h post-surgery were significantly lower in Group ES than in Group S ( P < 0.05). Additionally, the RSS scores were significantly higher at 6 h ( P = 0.032) and 12 h ( P = 0.021) post-surgery in Group ES. The frequency of PCIA postoperative use within 48 h post-surgery decreased ( P = 0.021) in Group ES, while satisfaction with analgesia and QoR-15 scores increased ( P = 0.001 and P < 0.001, respectively). The incidences of postoperative dizziness and nausea/vomiting reduced ( P = 0.045 and P = 0.036, respectively) in Group ES, but one adverse event of nightmare was observed. There was no significant difference in rescue analgesia between the two groups. Conclusion The use of esketamine combined with sufentanil in patients undergoing third molar surgery and maxillofacial trauma can alleviate short-term postoperative pain, and improve the quality of postoperative recovery. Esketamine is worth promoting in the clinical application of oral and maxillofacial surgery. Trial registration The study was retrospectively registered in chictr.org.cn with the identifier: ChiCTR2400086662 on 08/07/2024. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-024-05273-8.

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The Influence of Chlorhexidine Mouthwash Use on Post-Operative Infection Rate of Dental Implants- A Systematic Review

AlShahrani,

Alhussainan,

Al-Mofareh

et al. 2023

Arch Pharm Pract

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Does Sub-Anesthetic Ketamine Provide Postoperative Analgesia for Third Molar Surgery?

Cited by 3 publications

References 27 publications

A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study

A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study

The effect of esketamine combined with sufentanil based patient-controlled intravenous analgesia for postoperative pain in patients undergoing third molar surgery and maxillofacial trauma: a randomized clinical trial

The Influence of Chlorhexidine Mouthwash Use on Post-Operative Infection Rate of Dental Implants- A Systematic Review

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