Is Preemptive Oral Tizanidine Effective on Postoperative Pain Intensity after Bimaxillary Orthognathic Surgery? A Triple-Blind Randomized Clinical Trial

Dadmehr, Saleh; Shooshtari, Zahra; Alipour, Mohammad; Eshghpour, Majid; Shaban, Baratollah; Vaezi, Touraj; Samieirad, Sahand

doi:10.52547/wjps.11.2.37

Cited by 6 publications

(12 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The bias from the randomization process was low in all five studies. [ 9 10 11 12 13 ] Bias due to deviations from intended interventions (allocation concealment) was low in all five studies. [ 9 10 11 12 13 ] Bias arising due to missing outcome data was low in four studies[ 9 10 11 12 ] with no information in one study.…”

Section: Resultsmentioning

confidence: 99%

“…[ 9 10 11 12 13 ] Bias due to deviations from intended interventions (allocation concealment) was low in all five studies. [ 9 10 11 12 13 ] Bias arising due to missing outcome data was low in four studies[ 9 10 11 12 ] with no information in one study. [ 13 ] Bias in the measurement of outcome was low in four studies,[ 9 10 11 12 ] and there was no information in one study.…”

Section: Resultsmentioning

confidence: 99%

“…[ 9 10 11 12 13 ] Bias arising due to missing outcome data was low in four studies[ 9 10 11 12 ] with no information in one study. [ 13 ] Bias in the measurement of outcome was low in four studies,[ 9 10 11 12 ] and there was no information in one study. [ 13 ] Bias arising due to the selection of reported results was low in four studies,[ 9 11 12 13 ] and there was no information in one study.…”

Section: Resultsmentioning

confidence: 99%

“…[ 5 6 7 8 ] Several studies investigated preoperative tizanidine as a component of multimodal analgesia perioperatively and its efficacy as an opioid-sparing medication. [ 9 10 11 12 13 ] To date, there has been no systematic review that investigated the safety and efficacy of oral tizanidine in adult patients undergoing elective surgeries. Therefore, we sought to assess the role of oral tizanidine premedication in adult patients undergoing various elective surgeries.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and safety of oral tizanidine premedication as pre-emptive analgesia in adult patients undergoing elective surgeries- A systematic review

Nair

Rangaiah

Borkar

2023

Saudi Journal of Anaesthesia

View full text Add to dashboard Cite

Tizanidine is a centrally acting α2 agonist which has been used as a premedication due to its opioid-sparing and sympatholytic properties. This systematic review assessed the safety and feasibility of oral tizanidine. After registering the protocol with PROSPERO (CRD42022368546), randomized controlled trials and non-randomized observational studies were searched in various databases. The primary outcome was intraoperative opioid use; the secondary outcomes were 24-hr opioid consumption, pain scores, time to rescue analgesia, and adverse events. The risk of bias scale was used to assess the quality of evidence. Out of 202 studies identified, five studies fulfilled the inclusion criteria. Intraoperative opioid consumption was significantly less in the tizanidine group (MD: -2.40; 95% CI: -4.22, -0.59; P = 0.010; I 2 = 0 %). The 24-hr opioid consumption was comparable between both groups (MD: -42.53, 95% CI: -91.45, 6.39; P = 0.09; I 2 = 99%). Time to rescue analgesia was comparable between both groups (MD: 308.22; 95% CI: -263.67, 880.11, P = 0.29, I 2 = 100%). Pain scores at 6 and 12 hours were comparable (MD: -1.37; 95% CI: -3.68, 0.94; P = 0.24; I 2 = 97%) and (MD: -1.76; 95% CI: -4.06, 0.53; P = 0.13; I 2 = 95%); however, at 24 hours the scores were better in the tizanidine group (MD: -1.10; 95% CI: -1.50, -0.69; P < 0.0001 I 2 = 0%). Although dry mouth was significantly more in the tizanidine group (MD: 5.35; 95% CI: 1.72, 16.62; P = 0.004; I 2 = 0%), postoperative nausea/vomiting and dizziness were comparable. Tizanidine reduces intraoperative opioid consumption without significant adverse events. However, it does not provide effective opioid-sparing analgesia or reduced opioid requirement in the first 24 hours after surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and safety of oral tizanidine premedication as pre-emptive analgesia in adult patients undergoing elective surgeries- A systematic review

Nair

Rangaiah

Borkar

2023

Saudi Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…After the bimaxillary orthognathic procedure, Dadmehr et al reported that the introduction of oral tizanidine was successful in lowering postoperative soreness [ 28 ]. Following orthognathic surgery, acute chronic postoperatively pain can be predicted using the pain catastrophizing scale and presurgical conditioned pain modulation [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Recovery following Orthognathic Surgery Procedures—A Pilot Study

Dinu

Manea

Tomoiagă

et al. 2022

IJERPH

View full text Add to dashboard Cite

This study aims at evaluating and categorizing patients’ objective and subjective postoperative recovery symptoms after bimaxillary orthognathic surgery assigning the healing process. The patients were monitored throughout the recovery process, and their symptoms were managed. A prospective, observational study was performed. Patients with Class II and III malocclusion (aged 18 to 35) were evaluated and monitored preoperatively, and postoperatively at 48 h, 2 weeks, 1 month, and 3 months postsurgery. A questionnaire was used to assess pain and anesthesia/hypoesthesia. The most common objective and subjective signs that were correlated with the healing process were edema, hematoma, trismus, pain, and anesthesia/hypoesthesia. Edema peaked at 48–72 h postoperatively (distance between eye’s external canthus and gonion, mean difference = 4.53, between tragus and cheilion, mean difference = 7, between tragus and gnathion, mean difference = 4.65, p < 0.001); mouth opening amplitude was significantly decreased during the first two weeks postsurgery (class II, mean difference = 32.42, p = 0.006, class III, mean difference = 44.57, p < 0.001), but it steadily and considerably improved over three months. The nose tended to widen postsurgery. The most severe pain experienced by patients was of medium intensity in the mandibular body, described as pressure, and usually did not spread. Patients were most severely and persistently impacted by anesthesia/hypoesthesia.

show abstract

The Beneficial Effect of Preoperative Dexmedetomidine in Controlling Postoperative Pain, Nausea, and Vomiting After Orthognathic Surgery: A Triple-blind Randomized Clinical Trial

Labafchi¹,

Shooshtari²,

Grillo³

et al. 2023

Journal of Oral and Maxillofacial Surgery

View full text Add to dashboard Cite

Is Preemptive Oral Tizanidine Effective on Postoperative Pain Intensity after Bimaxillary Orthognathic Surgery? A Triple-Blind Randomized Clinical Trial

Cited by 6 publications

References 25 publications

Efficacy and safety of oral tizanidine premedication as pre-emptive analgesia in adult patients undergoing elective surgeries- A systematic review

Efficacy and safety of oral tizanidine premedication as pre-emptive analgesia in adult patients undergoing elective surgeries- A systematic review

Recovery following Orthognathic Surgery Procedures—A Pilot Study

The Beneficial Effect of Preoperative Dexmedetomidine in Controlling Postoperative Pain, Nausea, and Vomiting After Orthognathic Surgery: A Triple-blind Randomized Clinical Trial

Contact Info

Product

Resources

About