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KMID : 1040020180090010035
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International Journal of Pain
2018 Volume.9 No. 1 p.35 ~ p.40
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Pre-emptive Analgesic Effect of Diclofenac vs Aceclofenac on Postoperative Pain after Mandibular Third Molar Extraction
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Arif Md. Zeeshan
Lalitha Ramanujapuram Manikarnike
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Abstract
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Background: Postoperative pain associated with removal of mandibular third molars has been documented from moderate to severe during the first 24 hours after surgery, with pain peaking between 6 and 8 hours when a conventional local anaesthetic is used. In order to minimise the duration and intensity of post-operative pain the use of pre-emptive analgesia is currently recommended.
Methods: A total of 40 patients, who underwent third molar extraction under local anaesthesia were randomized into two groups,20 each, using a series of random numbers: Group A, was administered 100 mg of diclofenac; and Group B, 100mg aceclofenac. Drugs were administered orally 1 hour prior to surgery. Pain was recorded every 2 hourly till 24 hours after the surgery using VAS. Statistical analysis was done using Chi-square tests and Mann Whitney tests.
Results: Aceclofenac group had less pain post operatively at all the time intervals. The difference was statistically significant at 8hours (P value = .043), 10 hours (P value = .041), 12 hours (P value = .007) and 24 hours (P value < .0001). The rescue medication (acetaminophen) was taken at 4 hours at the earliest in the diclofenac group and at 8hours in the aceclofenac group. The number of relief medications (acetaminophen) taken by the aceclofenac group (one) was significantly lower than the diclofenac group (five) [P value = .0217].
Conclusions: A single pre-emptive dose of oral aceclofenac 100mg is more effective than pre-emptive oral diclofenac 100mg after third molar extractions. Aceclofenac has rapid onset and longer duration of action as compared to diclofenac.
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KEYWORD
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aceclofenac, diclofenac, pre-emptive analgesia, pain reduction, third molar surgery analgesia
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