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评价普瑞巴林和地塞米松联合给药对第三磨牙手术超前多模式镇痛和焦虑的影响:一项三盲随机临床试验。

Evaluation of the effects of pregabalin and dexamethasone coadministration on preemptive multimodal analgesia and anxiety in third molar surgeries: a triple-blind randomized clinical trial.

机构信息

Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, 50100-130, PE, Brazil.

Professor of Oral and Maxillofacial Surgery, University of Pernambuco, Recife, PE, Brazil.

出版信息

Clin Oral Investig. 2024 May 8;28(6):304. doi: 10.1007/s00784-024-05700-8.

Abstract

OBJECTIVE

To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery.

MATERIALS AND METHODS

A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO)], and sedation assessed by the Ramsay scale.

RESULTS

A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects.

CONCLUSIONS

Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect.

CLINICAL RELEVANCE

The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries.

TRIAL REGISTRATION

Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.

摘要

目的

评估普瑞巴林和地塞米松联合用于预防性镇痛和控制下颌第三磨牙手术焦虑的疗效。

材料和方法

采用三盲、分口临床试验,将患者分为两组:对照组给予安慰剂和地塞米松,实验组给予普瑞巴林和地塞米松术前用药。评估变量包括疼痛(视觉模拟评分法[VAS])、焦虑(状态-特质焦虑问卷[STAI])、血流动力学参数[血压(BP)、心率(HR)、血氧饱和度(SpO2)]和镇静(Ramsay 评分)。

结果

共纳入 31 例患者。实验组术后 2、4、6、8、12、16、24 和 48 小时疼痛明显减轻,解救性镇痛药用量减少。实验组 STAI 和 VAS 评估的焦虑显著降低(p<0.001)。此外,大多数评估时间点的 BP 显著降低(p<0.05),两个不同时间间隔的 HR 显著降低(p=0.003 和 p=0.009),提示实验组有积极作用。两组间 SpO2 无显著差异。镇静评估显示各时间点均有显著差异,实验组有优势(p<0.05)。术后无明显不良反应。

结论

普瑞巴林联合地塞米松可显著控制术后疼痛和焦虑,具有镇静作用。

临床相关性

普瑞巴林联合地塞米松给药可能在调节下颌第三磨牙手术患者的疼痛和心理状态方面具有潜在优势。

试验注册

巴西临床试验注册(REBEC),编号 RBR-378h6t6。

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