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Combination of etodolac and dexamethasone improves preemptive analgesia in third molar surgery: a randomized study

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Abstract

Objective

This randomized, controlled, triple-blind, crossover clinical trial aimed to investigate the use of dexamethasone (DEX) and etodolac (ETO) as preemptive analgesia before mandibular third molar extraction.

Methods

Patients were divided into three groups (n = 20 teeth each) based on the drug administered: DEX 8 mg (DEX); DEX 8 mg plus ETO 300 mg (DEX + ETO), and ETO 300 mg (ETO). Paracetamol (750 mg) tablets were administered as rescue analgesics. Pain was evaluated using the visual analog scale (VAS) at 6, 12, 24, 48, and 72 h and 7 days postoperatively. Edema and trismus were assessed 48 and 72 h postoperatively. All data were subjected to statistical analysis, where a P value < .05 indicated statistical significance.

Results

VAS scores and the number of rescue analgesics taken were lower in the DEX + ETO group than in the other groups (P < .001 and P = .014, respectively). At 48 h, trismus was similar among all groups; however, the ETO group showed the highest trismus 7 days postoperatively (P < .05). Edema was similar among all groups at all time points (P > .05).

Conclusion

The combined use of the anti-inflammatory drugs, DEX and ETO, resulted in better pain control and the need for fewer rescue analgesics than the use of either drug alone, which indicated their effectiveness in mandibular third molar extractions preoperatively.

Clinical relevance

This drug combination can lead to less pain, edema, and trismus and reduce the use of rescue analgesics in the postoperative period.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Finance Code 001.

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Authors and Affiliations

  1. Department of Diagnosis and Surgery, Sao Paulo State University (UNESP), School of Dentistry, Aracatuba, 1193 Jose Bonifacio St, Aracatuba, São Paulo, 16015-050, Brazil

    Guilherme André D. Ramires, Anderson Maikon de Souza Santos, Gustavo A. C. Momesso, Tárik Ocon B. Polo, William P. P. Silva, Stéfany Barbosa, Ana Paula F. Bassi & Leonardo Perez Faverani

Authors
  1. Guilherme André D. Ramires
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  2. Anderson Maikon de Souza Santos
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  3. Gustavo A. C. Momesso
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  4. Tárik Ocon B. Polo
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  5. William P. P. Silva
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  6. Stéfany Barbosa
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  7. Ana Paula F. Bassi
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  8. Leonardo Perez Faverani
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Correspondence to Leonardo Perez Faverani.

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The authors declare that they have no conflict of interest.

Ethics

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (#818.680) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ramires, G.A.D., de Souza Santos, A.M., Momesso, G.A.C. et al. Combination of etodolac and dexamethasone improves preemptive analgesia in third molar surgery: a randomized study. Clin Oral Invest 25, 2297–2305 (2021). https://doi.org/10.1007/s00784-020-03552-6

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  • DOI: https://doi.org/10.1007/s00784-020-03552-6

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