Pre-emptive analgesic efficacy of injected ketorolac in comparison to other agents for third molar surgical removal: a systematic review.

Autor:	Tirupathi S; Department of Pedodontics & Preventive Dentistry, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India., Rajasekhar S; Department of Pedodontics & Preventive Dentistry, Malla Reddy Dental College for Women, Hyderabad, Telangana, India., Maloth SS; Department of Periodontics, Mamata Dental College, Khammam, Telangana, India., Arya A; Department of Periododntics, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India., Tummalakomma P; Department of Periododntics, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India., Lanke RB; Familia Dental LLC, Texas, USA.
Jazyk:	angličtina
Zdroj:	Journal of dental anesthesia and pain medicine [J Dent Anesth Pain Med] 2021 Feb; Vol. 21 (1), pp. 1-14. Date of Electronic Publication: 2021 Jan 29.
DOI:	10.17245/jdapm.2021.21.1.1
Abstrakt:	This study aimed to evaluate and compare the pre-emptive analgesic efficacy of injected ketorolac to that of other agents for impacted third molar surgical removal in a healthy population. PubMed, Ovid SP, Cochrane databases were filtered from 1980 to July 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria independently by reviewers. Studies that compared pre-emptive intramuscular or intravenous administration of ketorolac to other agents were evaluated. The outcomes sought were self-reported postoperative pain (patient-perceived pain), median duration for rescue analgesic medication, total number of analgesics consumed in the recovery period, and global assessment (overall patient satisfaction) after the recovery period. Six studies were included in the final evaluation. The outcome of pain perception and the number of analgesics taken were significantly lower in the ketorolac group (intramuscular or intravenous) in most of the studies (n=5) than in the group of other drugs. The mean time for rescue analgesia intake was higher for the ketorolac group, and global assessment scores were also better in the ketorolac group. Although the included studies show significantly better outcomes such as postoperative pain, median time taken for rescue medication, total number of analgesics taken, and overall patient satisfaction with injected ketorolac group in comparison to injected diclofenac, dexamethasone, and tramadol, definitive conclusions cannot be made regarding the superiority of injected Ketorolac as a pre-emptive agent. A greater number of randomized control trials with a proper protocol are needed to make definitive conclusions. Competing Interests: DECLARATION OF INTEREST: There are no conflicts of interest to declare. (Copyright © 2021 Journal of Dental Anesthesia and Pain Medicine.)
Databáze:	MEDLINE
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