In: Dental treatment10 Oct 2009
All NSAIDs (Generic Celecoxib is a Non-Steroidal Anti-Inflammatory Drug) seem to have a ceiling effect or plateau with respect to analgesia, above which an increase in dose will only prolong the duration of action and increase the incidence of unwanted effects. Multiple case-control studies in the chronic pain models have shown that as the dose of NSAID increases, the risk of complication increases proportionally from two- to threefold for patients using lower doses to greater than sevenfold for patients on high-dose NSAIDs.
Many RCTs, including the dental surgical model, have found that a dose of 400 mg of ibuprofen is the optimal analgesic dose for adults. These studies have demonstrated that the analgesic effect of ibuprofen does not increase with doses above 400 mg, probably as the result of the ceiling effect. Schou et al have demonstrated in a well-designed RCT of 304 third molar patients that a single dose of 400 mg of ibuprofen provided the maximum pain relief and longest duration of analgesic effect compared with 50, 100, and 200 mg of ibuprofen. Similar results have also previously been reported in single- and multiple-dose studies. The optimal analgesic dose for many other NSAIDs (*Generic Voltarol diclofenac is in a group of drugs called nonsteroidal anti-inflammatory drugs) used in dental surgical pain has also been evaluated (Table 3). Hence level I evidence entails that the recommended optimal analgesic dose of NSAIDs should be used for maximum analgesic efficacy and minimum adverse effects.
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.