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Analgesic efficacy of butorphanol and tramadol in mandibular third molar surgery
Int. J. Oral Maxillofac. Surg. 2007; 36: 1006–1010 doi:10.1016/j.ijom.2007.08.166, available online at http://www.sciencedirect.com
O6. Dento alveolar surgery O6.1 Prophylactic antibiotic use for dentoalveolar surgery in wellcontrolled Diabetic-A necessity? K. Suneela Rani*, R.M. Lalitha, K. Prasad, K. Ranganath Department of OMFS, M.S. Ramaiah Dental College and Hospital, Opp. M.S. Ramaiah Memorial Hospital, New BEL Road, MSRIT Post, Bangalore 560054, India Patients with diabetes, especially type II are frequently encountered in Oral and Maxillofacial setup for various oral surgical procedures. It is in the hands of the Oral Surgeon to determine the general health and diabetic status of the patient and proceed further with the appropriate treatment; with or without antibiotic prophylaxis. There is no scientific evidence in the literature to support the premise that well-controlled or even moderately well-controlled non ketotic diabetic patients are prone to infection when undergoing uncomplicated dentoalveolar surgery. In order to prevent the development of resistant strains antibiotics should not be used indiscriminately. A study is being conducted in the Dept. of OMFS, MSRDC, B’lore to determine whether routine antibiotic prophylaxis is a necessity in well-controlled type II diabetics, for uncomplicated dentoalveolar surgery which may include simple extractions, alveoloplasty, etc. Patients are categorized into two groups- group A (control group), where pre op or post op antibiotics will be given and group B (study group), where antibiotics will not be given. The results will be presented and discussed. doi:10.1016/j.ijom.2007.08.167 0901-5027/1101006 + 05 $30.00/0
O6.2 Efficacy of dexamethasone in wisdom tooth extraction—a double blind split technique S. Gupta*, M. Padhyae Padmashree Dr D Y Patil Dental College and Hospital, Nerul, Navi Mumbai 400706, India Surgical removal of wisdom teeth under local anaesthesia is most commonly done in oral surgery O.P.D. it is usually associated with post-operative pain, swelling and trismus, which is one of the major concern of an oral surgeon. The use of steriods to decrease post-operative pain, swelling and trismus is well documented. The effect of submucosal administration of dexamethasone to prevent the inflammatory sequelae was studied. Hundred patients were studied who underwent surgical removal of bilateral third molars in two appointments on OPD basis. One site received injection dexamethasone and other site received injection saline. Both operator as well as the patient were blinded for the study. Post-operative pain, swelling and trismus were recorded on first, fourth and seventh post operative days. Pain by visual analogue scale, trismus by inter-incisal length before and after surgery; and swelling measuring from angle of the mouth to outer canthus of the eye and corner of the mouth to the attachment of ear lobe; were evaluated. The site which received injection dexamethasone showed considerable decrease in post-operative sequelae as compared to control site.
S. Siraj*, M. Rai KVG Dental College & Hospital Kurunjibagh Sullia DK, 574327 Karnataka, India Tramadol hydrochloride is a centrally acting opioid and Butorphanol tartrate a newer opioid which is a mixed synthetic agonist-antagonist opioid used for management of post-operative pain. The purpose of this study is to evaluate postoperative analgesic efficacy of Butorphanol tartrate 1 mg intramuscular in comparison with Tramadol hydrochloride 50 mg intramuscular after removal of impacted mandibular third molars in forty healthy individuals who were divided into two groups. In Group A, 20 patients were given butorphanol tartrate 1 mg intramuscular. In Group B, 20 patients were given Tramadol hydrochloride 50 mg intramuscular. After administration of study medications the efficacy of post-operative pain was evaluated for six hours or until the rescue analgesics used with maximum of 24 h duration using visual analog scale. Results: Group A 15 patients had vas score of 15 within 24 h. Group B 12 patients had vas score of more than 18 within 16 h. Conclusion: Butorphanol is potent analgesic in controlling postoperative pain after lower third molar impactions but has got high rate of nausea and vomiting as its side effects. Tramadol is a weaker analgesic then butorphanol. Both these drugs have comparatively low amount of drug dependence and respiratory depression.
doi:10.1016/j.ijom.2007.08.168
doi:10.1016/j.ijom.2007.08.169
O6.3
O6.4
Analgesic efficacy of butorphanol and tramadol in mandibular third molar surgery
Preferential COX-2 inhibitors in third molar surgery: a randomized, controlled triple blind study
O6. Dento alveolar surgery O6.1 Prophylactic antibiotic use for dentoalveolar surgery in wellcontrolled Diabetic-A necessity? K. Suneela Rani*, R.M. Lalitha, K. Prasad, K. Ranganath Department of OMFS, M.S. Ramaiah Dental College and Hospital, Opp. M.S. Ramaiah Memorial Hospital, New BEL Road, MSRIT Post, Bangalore 560054, India Patients with diabetes, especially type II are frequently encountered in Oral and Maxillofacial setup for various oral surgical procedures. It is in the hands of the Oral Surgeon to determine the general health and diabetic status of the patient and proceed further with the appropriate treatment; with or without antibiotic prophylaxis. There is no scientific evidence in the literature to support the premise that well-controlled or even moderately well-controlled non ketotic diabetic patients are prone to infection when undergoing uncomplicated dentoalveolar surgery. In order to prevent the development of resistant strains antibiotics should not be used indiscriminately. A study is being conducted in the Dept. of OMFS, MSRDC, B’lore to determine whether routine antibiotic prophylaxis is a necessity in well-controlled type II diabetics, for uncomplicated dentoalveolar surgery which may include simple extractions, alveoloplasty, etc. Patients are categorized into two groups- group A (control group), where pre op or post op antibiotics will be given and group B (study group), where antibiotics will not be given. The results will be presented and discussed. doi:10.1016/j.ijom.2007.08.167 0901-5027/1101006 + 05 $30.00/0
O6.2 Efficacy of dexamethasone in wisdom tooth extraction—a double blind split technique S. Gupta*, M. Padhyae Padmashree Dr D Y Patil Dental College and Hospital, Nerul, Navi Mumbai 400706, India Surgical removal of wisdom teeth under local anaesthesia is most commonly done in oral surgery O.P.D. it is usually associated with post-operative pain, swelling and trismus, which is one of the major concern of an oral surgeon. The use of steriods to decrease post-operative pain, swelling and trismus is well documented. The effect of submucosal administration of dexamethasone to prevent the inflammatory sequelae was studied. Hundred patients were studied who underwent surgical removal of bilateral third molars in two appointments on OPD basis. One site received injection dexamethasone and other site received injection saline. Both operator as well as the patient were blinded for the study. Post-operative pain, swelling and trismus were recorded on first, fourth and seventh post operative days. Pain by visual analogue scale, trismus by inter-incisal length before and after surgery; and swelling measuring from angle of the mouth to outer canthus of the eye and corner of the mouth to the attachment of ear lobe; were evaluated. The site which received injection dexamethasone showed considerable decrease in post-operative sequelae as compared to control site.
S. Siraj*, M. Rai KVG Dental College & Hospital Kurunjibagh Sullia DK, 574327 Karnataka, India Tramadol hydrochloride is a centrally acting opioid and Butorphanol tartrate a newer opioid which is a mixed synthetic agonist-antagonist opioid used for management of post-operative pain. The purpose of this study is to evaluate postoperative analgesic efficacy of Butorphanol tartrate 1 mg intramuscular in comparison with Tramadol hydrochloride 50 mg intramuscular after removal of impacted mandibular third molars in forty healthy individuals who were divided into two groups. In Group A, 20 patients were given butorphanol tartrate 1 mg intramuscular. In Group B, 20 patients were given Tramadol hydrochloride 50 mg intramuscular. After administration of study medications the efficacy of post-operative pain was evaluated for six hours or until the rescue analgesics used with maximum of 24 h duration using visual analog scale. Results: Group A 15 patients had vas score of 15 within 24 h. Group B 12 patients had vas score of more than 18 within 16 h. Conclusion: Butorphanol is potent analgesic in controlling postoperative pain after lower third molar impactions but has got high rate of nausea and vomiting as its side effects. Tramadol is a weaker analgesic then butorphanol. Both these drugs have comparatively low amount of drug dependence and respiratory depression.
doi:10.1016/j.ijom.2007.08.168
doi:10.1016/j.ijom.2007.08.169
O6.3
O6.4
Analgesic efficacy of butorphanol and tramadol in mandibular third molar surgery
Preferential COX-2 inhibitors in third molar surgery: a randomized, controlled triple blind study