In: Anesthesia25 Oct 2009
Pstoperative pain following surgical removal of a mandibular third molar is a validated, well-documented, and highly sensitive model to assess therapeutic relief of moderate to severe pain. Despite the availability of potent analgesics, postoperative pain remains a routine problem in ambulatory oral surgery. Following surgical removal of impacted third molar teeth, pain intensity is said to be maximal 3-5 hours after surgery.At this stage, the effects of short-acting local anesthetics are usually wearing off.
Tramadol [tramadol hydrochloride: (IRS, 2RS)-2-[(di-methylamine) methyl)-1-(3 methoxyphenyl)—cyclohex-anol HCL] is a synthetic 4-phenyl-piperidine analogue of codeine. Tramadol’s efficacy over a wide range of acute and chronic pain states, its multiformulation availability, and its low serious side-effect potential at high doses and in prolonged therapy, combine to bestow on it a user-friendly profile for short- and long-term use in hospitals and communities. The marketed formulations of tramadol contain a racemic mixture of 2 enantiomers (50:50), each one displaying differing affinities for various receptors. The complementary and synergistic mode of action of these 2 enantiomers is both opioid and monoaminergic, so that its analgesic effect extends to both opioid-sensitive and -insensitive pain. cheap generic levitra
Propofol, an emulsion formulation of isopropylphen-ol, is a suitable drug for sedation because its pharmacokinetic profile suggests a high total body clearance and a short elimination half-life after both bolus injection and brief infusions. This suggests a rapid recovery with a low incidence of excitatory effects. Propofol appears to be safe and efficacious for use during outpatient oral surgical procedures.
This pilot study was designed in a double-blind, randomized, placebo-controlled manner to evaluate the analgesic efficacy and clinical acceptability of intravenous tramadol/propofol versus placebo/propofol in patients undergoing surgical removal of an impacted third molar tooth under local anesthesia and intravenous sedation.
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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.