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비스테로이드성 항염진통제의 투여시기가 구강외과 술 후 통증에 미치는 효과에 대한 연구

The Effects on Postoperative Oral Surgery Pain by Varying NSAIDs Administration Times

대한치과마취과학회지 2004년 4권 2호 p.84 ~ 89
정영수, 박형식, 김문기, 엄유정, 이의웅, 강정완,
소속 상세정보
정영수 ( Jung Young-Soo ) - 연세대학교 치과대학 구강악안면외과학교실
박형식 ( Park Hyeong-Sik ) - 연세대학교 치과대학 구강악안면외과학교실
김문기 ( Kim Moon-Ki ) - 연세대학교 치과대학 구강악안면외과학교실
엄유정 ( Uhm Yoo-Jung ) - 연세대학교 치과대학 구강악안면외과학교실
이의웅 ( Lee Ui-Ung ) - 연세대학교 치과대학 구강악안면외과학교실
강정완 ( Kang Jeong-Wan ) - 연세대학교 치과대학 구강악안면외과학교실

Abstract


Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain.

Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score {ge} 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours.

Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups.

Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.

키워드

Administration time; Impacted mandibular third molar; Postoperative pain; Preemptive analgesia

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