Does the Preemptive Use of Oral Nonsteroidal Anti-inflammatory Drugs Reduce Postoperative Pain in Surgical Removal of Third Molars? A Meta-analysis of Randomized Clinical Trials

The purpose of this study was to investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) in third-molar surgery. A PubMed literature search was conducted for articles restricted to the English language using the following terms (DeCS/MeSH) or combinat...

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Bibliographic Details
Published in:Anesthesia progress 2015-01, Vol.62 (2), p.57-63
Main Authors: Costa, Fábio Wildson Gurgel, Esses, Diego Felipe Silveira, de Barros Silva, Paulo Goberlânio, Carvalho, Francisco Samuel Rodrigues, Sá, Carlos Diego Lopes, Albuquerque, Assis Filipe Medeiros, Bezerra, Tácio Pinheiro, Ribeiro, Thyciana Rodrigues, Sá Roriz Fonteles, Cristiane, Soares, Eduardo Costa Studart
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Dentistry
Humans
Mandible - surgery
Molar, Third - surgery
Pain, Postoperative - prevention & control
Premedication
Randomized Controlled Trials as Topic
Scientific Reports
Tooth Extraction - adverse effects
Tooth, Impacted - surgery
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Summary:The purpose of this study was to investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) in third-molar surgery. A PubMed literature search was conducted for articles restricted to the English language using the following terms (DeCS/MeSH) or combinations: analgesia, third molar, and preemptive. From a total of 704 articles, 6 (n=420 subjects) were selected. All studies presented a low risk of bias (Cochrane criteria) but exhibited high heterogeneity of methods. Two studies were excluded from the meta-analysis because they did not have adequate numeric values (dichotomous data) for the calculations. Preemptive analgesia showed no significant benefit (n=298, P=.2227, odds ratio: 2.30, 0.60-8.73) in reducing postoperative pain after removal of lower impacted third molars. However, there was a probable direct relationship between the effectiveness of NSAIDs in preemptive analgesia for removal of third molars and its selectivity for the cyclooxygenase-2 (COX-2). Preemptive analgesia did not have a significant effect in reducing postoperative pain after removal of lower impacted third molars. More homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs' selectivity for COX-2 and treatment effectiveness.
ISSN:0003-3006
1878-7177
DOI:10.2344/0003-3006-62.2.57