Intravenous ibuprofen versus diclofenac plus orphenadrine in orthognathic surgery: a prospective, randomized, double-blind, controlled clinical study.

Autor: Tomic J; Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria. jo.to@hotmail.de., Wallner J; Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria., Mischak I; Department of Dental Medicine and Oral Health, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria., Sendlhofer G; Executive Department for Quality and Risk ManagementDivision of Plastic, Aesthetic and Reconstructive SurgeryDepartment of Surgery, Research Unit for Safety in Health, Medical University of Graz, Graz, Austria., Zemann W; Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria., Schanbacher M; Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria., Hassanzadeh H; Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA., Sandner-Kiesling A; Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Styria, Austria., Payer M; Department of Dental Medicine and Oral Health, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria., Zrnc TA; Department of Oral and Maxillofacial Surgery, University Hospital, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, , Styria, Austria.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2022 May; Vol. 26 (5), pp. 4117-4125. Date of Electronic Publication: 2022 Feb 01.
DOI: 10.1007/s00784-022-04381-5
Abstrakt: Objectives: The aim of this prospective, randomized, double-blind, controlled clinical study was to evaluate the analgesic effect of ibuprofen versus diclofenac plus orphenadrine on postoperative pain in orthognathic surgery.
Material and Methods: Patients who underwent orthognathic surgery were randomized into two groups to receive intravenously either 600 mg of ibuprofen (I-group) or 75 mg diclofenac plus 30 mg orphenadrine (D-group), both of which were given twice daily. Additionally, both groups were given metamizole 500 mg. Rescue pain medication consisted of acetaminophen 1000 mg and piritramide 7.5 mg as needed. To assess the pain intensity, the primary end point was the numeric rating scale (NRS) recorded over the course of the hospital stay three times daily for 3 days.
Results: One hundred nine patients were enrolled (age range, 18 to 61 years) between May 2019 and November 2020. Forty-eight bilateral sagittal split osteotomies (BSSO) and 51 bimaxillary osteotomies (BIMAX) were performed. Surgical subgroup analysis found a significant higher mean NRS (2.73 vs.1.23) in the BIMAX D-group vs. I-group (p = 0.015) on the third postoperative day. Additionally, as the patient's body mass index (BMI) increased, the mean NRS (r = 0.517, p = 0.001) also increased. No differences were found between age, gender, length of hospital stay, weight, operating times, number of patients with complete pain relief, acetaminophen or piritramide intake, and NRS values. No adverse events were observed.
Conclusion: The results of this study demonstrate that ibuprofen administration and lower BMI were associated with less pain for patients who underwent bimaxillary osteotomy on the third postoperative day. Therefore, surgeons may prefer ibuprofen for more effective pain relief after orthognathic surgery.
Clinical Relevance: Ibuprofen differs from diclofenac plus orphenadrine in class and is a powerful analgetic after orthognathic surgery.
(© 2022. The Author(s).)
Databáze: MEDLINE
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