Perepa Anisha, Sinha Brig Ramen, Uppada Uday Kiran, Kumar Avss Subramanya
Sri Sai College of Dental Surgery, Vikarabad, India.
Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India.
J Maxillofac Oral Surg. 2017 Jun;16(2):170-174. doi: 10.1007/s12663-016-0941-3. Epub 2016 Jul 9.
To evaluate the analgesic efficacy of a diclofenac transdermal patch with diclofenac intra muscular injection in the immediate postoperative period in patients undergoing major oral surgical procedures.
Subjects who underwent bijaw surgeries for surgical correction of various dentofacial deformities were included. Sixty such patients who belonged to the above entity were randomly categorized into two groups from Jan 2012-Aug 2015. Group A (study group) received a single dose of 100 mg transdermal diclofenac patch, Group B (control group) received 75 mg intramuscular diclofenac and tramadol HCl 2 mg/kg body wt was used as rescue analgesic in the immediate post operative phase. The analgesic efficacy of the drugs are evaluated on periodic patient's perception of pain in the immediate postoperative phase of 2nd, 6th, 12th, 24th and 48 hours.
The mean VAS score in Group A was 2, mean duration of analgesia was 16 h 9 min, and in Group B the mean VAS score was 4, duration of analgesia was 8 h and 4 min. Tramadol HCl was given as rescue analgesia in 22 % (6) of patients belonging to Group A. None of the patients from both the groups reported local complications.
A noninvasive application of a single dose of 100 mg transdermal diclofenac patch is more effective than intramuscular diclofenac (75 mg) in the immediate post operative phase, without any significant side-effects is a novel ingress into the field of oral and maxillofacial surgery for post operative pain management.
评估双氯芬酸透皮贴剂与双氯芬酸肌肉注射在接受大型口腔外科手术患者术后即刻的镇痛效果。
纳入因各种牙颌面畸形接受双颌手术进行手术矫正的受试者。2012年1月至2015年8月,60名属于上述类型的患者被随机分为两组。A组(研究组)接受单剂量100mg双氯芬酸透皮贴剂,B组(对照组)接受75mg双氯芬酸肌肉注射,术后即刻使用2mg/kg体重的盐酸曲马多作为解救镇痛药。在术后第2、6、12、24和48小时的即刻术后阶段,根据患者对疼痛的周期性感知来评估药物的镇痛效果。
A组的平均视觉模拟评分(VAS)为2分,平均镇痛持续时间为16小时9分钟,B组的平均VAS评分为4分,镇痛持续时间为8小时4分钟。A组22%(6名)患者使用盐酸曲马多作为解救镇痛药。两组均无患者报告局部并发症。
在术后即刻阶段,单剂量100mg双氯芬酸透皮贴剂的无创应用比肌肉注射双氯芬酸(75mg)更有效,且无任何明显副作用,这是口腔颌面外科术后疼痛管理领域的一种新方法。