NSAID chronotherapy after impacted third molar extraction: a randomized controlled trial.
Chronotherapy
Drug chronotherapy
Molar
NSAIDs
Pain management
Third
Tooth extraction
Journal
Oral and maxillofacial surgery
ISSN: 1865-1569
Titre abrégé: Oral Maxillofac Surg
Pays: Germany
ID NLM: 101319632
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
01
10
2021
accepted:
10
12
2021
pubmed:
23
1
2022
medline:
11
11
2022
entrez:
22
1
2022
Statut:
ppublish
Résumé
Postoperative pain management impacts patients' quality of life and morbidity. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are widely used for this following a 3-doses-per-day regime. However, pain and inflammation follow a circadian rhythm, and animal models assessing the scheduling of NSAID administration (e.g., chronotherapy) have shown that while their use during the active phase of the day enhances postoperative recovery, their administration during the resting phase could have detrimental effects. This observation has led us to hypothesize that night administration of NSAID might be unnecessary in post-surgical scenarios. Therefore, a randomized clinical trial was conducted to test this hypothesis in surgical third molar extractions. Seventy (18-35 years) healthy participants requiring surgical removal of impacted lower third molars were recruited and randomized into a double-blind placebo-controlled study. For three days postoperatively, the treatment group (n = 33) received ibuprofen (400 mg) at 8 AM, 1 PM, and a placebo at 8 PM, while the control group (n = 37) received ibuprofen (400 mg) at 8 AM, 1 PM, and 8 PM. Pain severity was assessed by visual analog scale (VAS) and healing indicators including facial swelling, mouth opening, and C-reactive protein blood levels were also measured. Pain VAS measures showed a circadian variation peaking at night. Also, no significant differences were observed between the two groups of the study in terms of postoperative pain scores (estimate: 0.50, 95% CI = [- 0.38, 1.39]) or any other healing indicator. Postoperative pain follows a circadian rhythm. Moreover, night administration of ibuprofen might not provide any significant benefits in terms of pain management and control of inflammation, and two doses during the day only could be sufficient for pain management after surgical interventions. Even though this study cannot rule out the possibility that a reduced regime is different than a standard regime, nocturnal doses of ibuprofen seem to have no clinical significance in the short term, and the results of this study provide evidence in favor of reducing ibuprofen administration from three doses to two doses only after third molar surgery.
Identifiants
pubmed: 35064366
doi: 10.1007/s10006-021-01029-8
pii: 10.1007/s10006-021-01029-8
doi:
Substances chimiques
Anti-Inflammatory Agents, Non-Steroidal
0
Ibuprofen
WK2XYI10QM
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
663-672Subventions
Organisme : Jordan University of Science and Technology
ID : 20170307
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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