Preemptive analgesia in third molar surgery: A randomized clinical trial comparing two multimodal associations

Abstract

Objective: This study aimed to verify the effect of preemptive administration of dexamethasone 8 mg co-administered with paracetamol 1 g compared with dexamethasone 8 mg co-administered with nimesulide 100 mg in surgeries for extracting third molars. Methods: A prospective, randomized, triple-blind clinical trial was conducted, allocating patients into two groups by the split-mouth method: Group 1 received dexamethasone and paracetamol, and Group 2 received dexamethasone and nimesulide. Each patient underwent two surgeries on different occasions, evaluating the parameters: pain, number of consumed rescue analgesics, time to the first rescue analgesic consumption, edema, trismus, and patient satisfaction. Results: Similar results were found in pain, trismus, number of rescue analgesics ingested, time until ingesting the first rescue analgesic, and overall assessment variables. However, Group 1 showed better results regarding edema, with a statistically significant difference in the 48-h period (p=0.028). Conclusion: Dexamethasone 8 mg plus paracetamol 1 g is effective for preemptive analgesia.

Evaluation of preemptive and preventive use of coadministration of ibuprofen L-arginine and dexamethasone on clinical and laboratory parameters, quality of life, pain catastrophizing, and sleep quality in lower third molar surgeries: a randomized, split-mouth, controlled trial

“…[52] co-administered corticosteroids and NSAIDs, with results that corroborate with this study, where the drug combination proved effective in pain and in ammatory events control, resulting in less rescue medication consumption. Another study with a similar clinical methodology was Souza Júnior et al [53], which co-administered 8 mg of dexamethasone with 1 g of paracetamol, showing a similar response to the combination of dexamethasone 8 mg plus 100 mg of nimesulide in pain variables, trismus, number of rescue analgesics ingested, time until the rst rescue medication ingestion; with analgesic and global evaluation, without statistically signi cant differences. However, post-surgical edema had a statistically signi cantly better response within a 48-hour time frame in the group containing paracetamol.…”