Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | https://ri.ufs.br/handle/riufs/3823 |
Resumo: | The aim of the present randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia through a combination of tramadol+dexamethasone and tramadol+diclofenac sodium. Thirty patients were submitted to surgery for the bilateral removal of impacted lower third molars, with one side operated at a time. The first surgery was performed on one side with the preemptive oral administration of a single tablet of either tramadol+dexamethasone or tramadol+diclofenac sodium. The opposite side was operated a week later using the other drug combination. Anthropometric measurements and maximal mouth opening were determined in both the preoperative and postoperative period to assess the degree of swelling and trismus, respectively. As a rescue drug, the patients were permitted to use acetaminophen when needed to control postoperative pain. The patients were given a chart with a visual analog scale (VAS) to record postoperative pain and rescue drug intake. No statistically significant difference was detected with regard to pain intensity between the drug combinations (p = 0.08). Pain scores were lower with the tramadol+dexamethasone combination in comparison to the tramadol+diclofenac sodium combinations at the different evaluation times. With both protocols, mean VAS values were below 50 mm, representing moderate pain. With regard to trismus, the tramadol+dexamethasone combination allowed significantly greater postoperative mouth opening (p < 0.01). The tramadol+dexamethasone combination also demonstrated a significantly lesser degree of swelling, specifically for the measurements from the angle of the mandible to the ala of nose (p = 0.001), labial commissure (p < 0.001) and mentus (p < 0.001). No significant differences between the drug combinations were found regarding pain in the postoperative period following third molar surgery, as mild to moderate pain was reported using both protocols (determined by VAS values). With regard to inflammation, the tramadol+dexamethasone proved more effective than tramadol+diclofenac sodium, with statistically significant differences with regard to the degree of swelling and trismus. |
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Santos, Jadson Alípio Santana de Sousahttp://lattes.cnpq.br/4625759951222177Silva, Luiz Carlos Ferreira dahttp://lattes.cnpq.br/08287267015072702017-09-26T12:17:45Z2017-09-26T12:17:45Z2011-03-31https://ri.ufs.br/handle/riufs/3823The aim of the present randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia through a combination of tramadol+dexamethasone and tramadol+diclofenac sodium. Thirty patients were submitted to surgery for the bilateral removal of impacted lower third molars, with one side operated at a time. The first surgery was performed on one side with the preemptive oral administration of a single tablet of either tramadol+dexamethasone or tramadol+diclofenac sodium. The opposite side was operated a week later using the other drug combination. Anthropometric measurements and maximal mouth opening were determined in both the preoperative and postoperative period to assess the degree of swelling and trismus, respectively. As a rescue drug, the patients were permitted to use acetaminophen when needed to control postoperative pain. The patients were given a chart with a visual analog scale (VAS) to record postoperative pain and rescue drug intake. No statistically significant difference was detected with regard to pain intensity between the drug combinations (p = 0.08). Pain scores were lower with the tramadol+dexamethasone combination in comparison to the tramadol+diclofenac sodium combinations at the different evaluation times. With both protocols, mean VAS values were below 50 mm, representing moderate pain. With regard to trismus, the tramadol+dexamethasone combination allowed significantly greater postoperative mouth opening (p < 0.01). The tramadol+dexamethasone combination also demonstrated a significantly lesser degree of swelling, specifically for the measurements from the angle of the mandible to the ala of nose (p = 0.001), labial commissure (p < 0.001) and mentus (p < 0.001). No significant differences between the drug combinations were found regarding pain in the postoperative period following third molar surgery, as mild to moderate pain was reported using both protocols (determined by VAS values). With regard to inflammation, the tramadol+dexamethasone proved more effective than tramadol+diclofenac sodium, with statistically significant differences with regard to the degree of swelling and trismus.Este ensaio clínico aleatório e duplo-cego investigou o efeito da analgesia preemptiva da associação de tramadol+dexametasona e tramadol+diclofenaco de sódio, no controle de dor, trismo e edema. Trinta pacientes foram submetidos à cirurgia para remoção de terceiros molares inferiores bilaterais impactados e o paciente foi seu próprio controle. A primeira cirurgia foi, então, realizada no lado direito ou esquerdo e realizada a ingestão de um único comprimido da associação medicamentosa tramadol+dexametasona ou tramadol+diclofenaco de sódio, mediante técnica de aleatoriedade. O lado oposto foi operado após uma semana à primeira cirurgia. Para avaliação do grau de edema e trismo foram realizadas medidas antropométricas e de máxima abertura bucal, respectivamente, no período pré e pós-operatório. O paciente pôde utilizar, como medicação resgate, o paracetamol, sempre que necessário para controlar a dor pós-operatória. Após a cirurgia, foi fornecida para todos os pacientes uma ficha, contendo a escala visual analógica (EVA) e uma tabela para informar o consumo de medicação resgate. Não houve diferença estatisticamente significativa (p= 0,08) quanto à intensidade da dor entre associações medicamentosas avaliadas. Ao comparar-se a analgesia proporcionada pelo tramadol+dexametasona e tramadol+diclofenaco de sódio, os resultados mostraram que o protocolo tramadol+dexametasona apresentou menores escores de dor, comparado ao protocolo tramadol+diclofenaco de sódio, no controle da dor nos tempos avaliados. Além disso, em ambos os protocolos observou-se uma média de escores abaixo de 50 mm, o que representa uma dor do tipo moderada. Houve diferença significativa entre protocolos quanto às variáveis trismo (p<0,01), sendo o protocolo tramadol+dexametasona o que apresentou um menor trismo. Em relação ao edema pós-cirúrgico, também foi observado, diferença significativa, demonstrando menor edema para o protocolo tramadol+dexametasona, mais especificamente nas medidas ângulo asa do nariz (p= 0,001), comissura labial (p< 0,001) e mento (p< 0,001). Desse modo, constatou-se que os protocolos avaliados não mostraram diferenças significativas, quanto à redução da dor no período pós-operatório à cirurgia de terceiro molar, mas em ambos foram notificados escores de dor categorizados na EVA, como sendo uma dor leve a moderada. Em relação ao controle de inflamação, o protocolo tramadol+dexametasona mostrou ser mais eficaz, com diferenças estatísticas significativas quanto ao grau de edema e trismo comparado ao tramadol+diclofenaco de sódio.Coordenação de Aperfeiçoamento de Pessoal de Nível Superiorapplication/pdfporUniversidade Federal de SergipePós-Graduação em Ciências da SaúdeUFSBRAnalgesiaDor pós-operatóriaTerceiro molarAnalgesiaPostoperative painThird molarCNPQ::CIENCIAS HUMANAS::GEOGRAFIAEstudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molarCOMPARATIVE STUDY OF THE ANALGESIA PREEMPTIVE OF TRAMADOL AND COMBINED DEXAMETHASONE DICLOFENAC SODIUM IN THIRD MOLAR SURGERY.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSTEXTJADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.txtJADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.txtExtracted texttext/plain110312https://ri.ufs.br/jspui/bitstream/riufs/3823/2/JADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.txt2f5180f7eac7b0e8342f6185e6062d0bMD52THUMBNAILJADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.jpgJADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.jpgGenerated Thumbnailimage/jpeg1335https://ri.ufs.br/jspui/bitstream/riufs/3823/3/JADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf.jpgd44b8b8097aa0db3c028753fc1024de1MD53ORIGINALJADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdfapplication/pdf968486https://ri.ufs.br/jspui/bitstream/riufs/3823/1/JADSON_ALIPIO_SANTANA_SOUSA_SANTOS.pdf6f7eb01b18b913bf5523304e8cb4a5ffMD51riufs/38232017-11-28 16:43:44.064oai:ufs.br:riufs/3823Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2017-11-28T19:43:44Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.por.fl_str_mv |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
dc.title.alternative.eng.fl_str_mv |
COMPARATIVE STUDY OF THE ANALGESIA PREEMPTIVE OF TRAMADOL AND COMBINED DEXAMETHASONE DICLOFENAC SODIUM IN THIRD MOLAR SURGERY. |
title |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
spellingShingle |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar Santos, Jadson Alípio Santana de Sousa Analgesia Dor pós-operatória Terceiro molar Analgesia Postoperative pain Third molar CNPQ::CIENCIAS HUMANAS::GEOGRAFIA |
title_short |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
title_full |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
title_fullStr |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
title_full_unstemmed |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
title_sort |
Estudo comparativo da analgesia preemptiva do tramadol combinado a dexametasona e diclofenaco de sódio em cirurgia de terceiro molar |
author |
Santos, Jadson Alípio Santana de Sousa |
author_facet |
Santos, Jadson Alípio Santana de Sousa |
author_role |
author |
dc.contributor.author.fl_str_mv |
Santos, Jadson Alípio Santana de Sousa |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4625759951222177 |
dc.contributor.advisor1.fl_str_mv |
Silva, Luiz Carlos Ferreira da |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0828726701507270 |
contributor_str_mv |
Silva, Luiz Carlos Ferreira da |
dc.subject.por.fl_str_mv |
Analgesia Dor pós-operatória Terceiro molar |
topic |
Analgesia Dor pós-operatória Terceiro molar Analgesia Postoperative pain Third molar CNPQ::CIENCIAS HUMANAS::GEOGRAFIA |
dc.subject.eng.fl_str_mv |
Analgesia Postoperative pain Third molar |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS HUMANAS::GEOGRAFIA |
description |
The aim of the present randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia through a combination of tramadol+dexamethasone and tramadol+diclofenac sodium. Thirty patients were submitted to surgery for the bilateral removal of impacted lower third molars, with one side operated at a time. The first surgery was performed on one side with the preemptive oral administration of a single tablet of either tramadol+dexamethasone or tramadol+diclofenac sodium. The opposite side was operated a week later using the other drug combination. Anthropometric measurements and maximal mouth opening were determined in both the preoperative and postoperative period to assess the degree of swelling and trismus, respectively. As a rescue drug, the patients were permitted to use acetaminophen when needed to control postoperative pain. The patients were given a chart with a visual analog scale (VAS) to record postoperative pain and rescue drug intake. No statistically significant difference was detected with regard to pain intensity between the drug combinations (p = 0.08). Pain scores were lower with the tramadol+dexamethasone combination in comparison to the tramadol+diclofenac sodium combinations at the different evaluation times. With both protocols, mean VAS values were below 50 mm, representing moderate pain. With regard to trismus, the tramadol+dexamethasone combination allowed significantly greater postoperative mouth opening (p < 0.01). The tramadol+dexamethasone combination also demonstrated a significantly lesser degree of swelling, specifically for the measurements from the angle of the mandible to the ala of nose (p = 0.001), labial commissure (p < 0.001) and mentus (p < 0.001). No significant differences between the drug combinations were found regarding pain in the postoperative period following third molar surgery, as mild to moderate pain was reported using both protocols (determined by VAS values). With regard to inflammation, the tramadol+dexamethasone proved more effective than tramadol+diclofenac sodium, with statistically significant differences with regard to the degree of swelling and trismus. |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011-03-31 |
dc.date.accessioned.fl_str_mv |
2017-09-26T12:17:45Z |
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2017-09-26T12:17:45Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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https://ri.ufs.br/handle/riufs/3823 |
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https://ri.ufs.br/handle/riufs/3823 |
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por |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Universidade Federal de Sergipe |
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Pós-Graduação em Ciências da Saúde |
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UFS |
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BR |
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Universidade Federal de Sergipe |
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