Efficacy of Preemptive Analgesia on Post-operative Pain and Quality of Life among Patients Undergoing Mandibular Third Molar Surgery.
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Abstract
Background: It is unclear if pre-emptive analgesia is effective in pain control and improved quality of life following third molar surgery. The objective of this study was to determine the efficacy of pre-emptive plus postoperative versus postoperative analgesia alone on postoperative pain and quality of life (QoL) following lower third molar surgery.
Methods: This was a randomized, controlled, double blinded study performed at a Nigerian teaching hospital. Patients were randomly allocated in ratio 1: 1 into test group that received 50 mg diclofenac potassium 30 minutes pre-emptively and same drug post-operatively, 12 hourly for five days and the control group that received 50 mg diclofenac potassium postoperatively, 12 hourly for 5 days. The pain was assessed with a visual analogue scale at 4 hours, 8 hours, 12 hours, 24 hours, 48 hours, 72 hours, and day 7 postoperatively. The quality of life (QoL) was assessed with OHIP-14 questionnaire on days 1, 3 and 7 postoperatively. Both descriptive and inferential statistics were performed. A p value of less than 0.05 was considered statistically significant.
Results: The median age was 24 years and the male-to-female ratio was 1:1.4. At all-time points (4 hours, 8 hours, 12 hours, 24 hours, 48 hours, 72 hours and day 7), the pain scores were significantly lower in the test group compared to the control group (p<0.05). The QoL was significantly better in the test group compared to the control group on day 1 (p = 0.002) and day 3 (p = 0.006) but not different on day 7 (p = 0.135).
Conclusion: Pre-emptive plus postoperative analgesia was more efficacious in the control of postoperative pain and in improving the quality of life of patients than postoperative analgesia alone following mandibular third molar surgery.
Keywords: Third molar surgery, diclofenac potassium, preemptive, postoperative, analgesia, pain, quality of Life.