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BIBTEX RIS

Effect of pre-emptive analgesia on clinical parameters and tissue levels of TNF-α and IL-1β in third molar surgery: a triple-blind, randomized, placebo-controlled study

2017; Elsevier BV; Volume: 46; Issue: 12 Linguagem: Inglês

10.1016/j.ijom.2017.05.007

ISSN

1399-0020

Autores

Assis Filipe Medeiros Albuquerque, Cristiane Sá Roriz Fonteles, Danielle Rocha do Val, Hellíada Vasconcelos Chaves, Mirna Marques Bezerra, Karuza Maria Alves Pereira, P.G. de Barros Silva, Beatriz Barbosa de Lima, E.C.S. Soares, Thyciana Rodrigues Ribeiro, Fábio Wildson Gurgel Costa,

Tópico(s)

Cancer, Stress, Anesthesia, and Immune Response

Resumo

This study aimed to evaluate whether pre-emptive analgesia modifies the tissue expression of tumour necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β), and whether there is an association with postoperative surgical outcomes. A triple-blind, randomized, placebo-controlled study of patients undergoing mandibular third molar removal was performed. Volunteers were allocated randomly to receive etoricoxib 120 mg, ibuprofen 400 mg, or placebo 1 h before surgery. Twenty-four surgical sites per group were required (95% confidence level and 80% statistical power). Pain scores differed significantly between groups (P< 0.001). Etoricoxib and ibuprofen reduced pain scores compared to placebo (P< 0.05). Pain scores peaked at 4 h postoperative in the experimental groups, but at 2 h postoperative in the placebo group (P< 0.05). A significant reduction in TNF-α concentration from time 0′ to time 30′ was seen for ibuprofen (P = 0.001) and etoricoxib (P = 0.016). The ibuprofen group showed a significant reduction in IL-1β levels from time 0′ to time 30′ (P = 0.038). In conclusion, TNF-α and IL-1β levels and the inflammatory events in third molar surgery were inversely associated with the degree of cyclooxygenase 2 selectivity of the non-steroidal anti-inflammatory drugs used pre-emptively. Patients given pre-emptive analgesia showed significant reductions in the clinical parameters pain, trismus, and oedema when compared to the placebo group.

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