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. Issue 12 (December 2017)

• Record Type: Journal Article
• Authors: Albuquerque, A.F.M.; Fonteles, C.S.R.; do Val, D.R.; Chaves, H.V.; Bezerra, M.M.; Pereira, K.M.A.; de Barros Silva, P.G.; de Lima, B.B.; Soares, E.C.S.; Ribeiro, T.R.; Costa, F.W.G.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 46:Issue 12(2017:Dec.)
• Page Start: 1615
• Page End: 1625
• Publication Date: 2017-12
• Subjects: third molar -- inflammatory events -- TNF-α -- IL-1β -- non-steroidal anti-inflammatory drugs; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2017.05.007
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: 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.