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Medeiros-Albuquerque AF, Roriz-Fonteles CS, do Nascimento-Costa JJ, Viana-Silva JR, de Barros-Silva PG, Studart-Soares EC, Chaves FN, Alves-Pereira KM, Ribeiro TR, Gurgel-Costa FW. RT-qPCR study of COX-1 and -2 genes in oral surgical model comparing single-dose preemptive ibuprofen and etoricoxib: A randomized clinical trialy. J Clin Exp Dent 2020; 12:e371-e380. [PMID: 32382387 PMCID: PMC7195677 DOI: 10.4317/jced.56447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/27/2020] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to evaluate the gene expression of cyclooxygenases (COXs) in an oral model of preemptive analgesia.
Material and Methods Gingival tissue was collected during extraction of lower third molars from a randomized, triple-blind, split-mouth and placebo-controlled study. The eligible patients were randomly sorted to receive a single dose either of ibuprofen 400mg, or etoricoxib 120 mg or a placebo, one hour prior to surgery. The temporal course of RNAm was evaluated for COX-1 and -2 by means of a quantitative polymerase chain reaction in real time (RT-qPCR) at time zero and 30 minutes after the surgical procedure began, and it was correlated with clinical parameters (pain and maximum mouth opening).
Results There was a significant increase in COX-1 expression between T0 and T30 in ibuprofen (p=0.004) and etoricoxib (p=0.010) groups. As regards COX-2, there were increases from T0 to T30 in all groups (placebo, p=0.012; ibuprofen, p<0.001; etoricoxib, p<0.001). All groups showed a significant decrease in COX-2:COX-1 ratio from T0 to T30 (placebo, p=0.013; ibuprofen, p<0.001; etoricoxib, p=0.047). Experimental groups showed a significant correlation between COX-1 and COX-2 levels and clinical pain parameters.
Conclusions The present preemptive analgesia study concludes that COX-2 RNAm induction was directly linked to third molar-related tissue inflammation and that the relation between COX-1 and COX-2 levels were inversely proportional to the preemptively administered nonsteroidal anti-inflammatory drugs COX-2 selectivity. Key words:Preemptive analgesia, dental extraction, cyclooxygenases, real-time polymerase chain reaction.
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Affiliation(s)
| | - Cristiane-Sá Roriz-Fonteles
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | | | - José-Roberto Viana-Silva
- MSc, PhD, Biotechnology Nucleus of Sobral - NUBIS, School of Medicine, Federal University of Ceará, Sobral, Brazil
| | - Paulo-Goberlânio de Barros-Silva
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | - Eduardo-Costa Studart-Soares
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | - Filipe-Nobre Chaves
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | - Karuza-Maria Alves-Pereira
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | - Thyciana-Rodrigues Ribeiro
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
| | - Fábio-Wildson Gurgel-Costa
- DDS, MSc, PhD, Division of Clinical Dentistry, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
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Kien NT, Geiger P, Van Chuong H, Cuong NM, Van Dinh N, Pho DC, Anh VT, Giang NT. Preemptive analgesia after lumbar spine surgery by pregabalin and celecoxib: a prospective study. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:2145-2152. [PMID: 31308627 PMCID: PMC6613459 DOI: 10.2147/dddt.s202410] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/12/2019] [Indexed: 12/11/2022]
Abstract
Objective To evaluate the preemptive analgesic effect of combination pregabalin with celecoxib for lumbar spine surgery. Methods A prospective, randomized study was conducted among 60 lumbar spine surgery patients and divided into two groups. Postoperative pain relief was achieved with intravenous patient-controlled analgesia with morphine. The preemptive analgesia group received oral pregabalin (150 mg) and celecoxib (200 mg) 2 hrs before surgery, and the control group received a placebo. Pain was assessed by visual analogue scale (VAS). Side effects and morphine consumption were monitored until 48 hrs after surgery. Results VAS score at rest and during movement was statistically significantly lower in the preemptive analgesia group at most time points (p<0.05). Morphine consumption was significantly lower in the preemptive analgesia group compared with control group in the 24 first hours (29.03±4.38 mg vs 24.43±4.94) and 48 hrs (52.23±9.57 mg vs 44.20±10.21 mg), p<0.05. Hemodynamics, respiratory rate, and SpO2 were similar for both groups. The sedation score was only statistically significant at H8 time point. The incidence of nausea/vomiting in the preemptive group did not statistically differ from the control group. Conclusion Preoperative administration of pregabalin combined with celecoxib had a good preemptive analgesia effect and reduced intravenous morphine consumption after lumbar spine surgery. Side effects were mild and transient.
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Affiliation(s)
- Nguyen Trung Kien
- Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Phillip Geiger
- Department of Anesthesiology, Perioperative, and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - Hoang Van Chuong
- Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Manh Cuong
- Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Ngo Van Dinh
- Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Dinh Cong Pho
- Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam
| | - Vu The Anh
- Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Truong Giang
- Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
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Komasawa N, Yamamoto K, Ito Y, Omori M, Ueno T, Minami T. Preoperative Administration of Jidabokuippo, a Kampo Medicine, Alleviates Postoperative Pain after Tooth Extraction with Mandible Bone Removal under General Anesthesia: A Prospective, Single-Blind, Randomized Controlled Trial. J Altern Complement Med 2018; 24:1214-1218. [PMID: 29993259 DOI: 10.1089/acm.2018.0244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to determine the efficacy of preoperative administration of Jidabokuippo (JDI), a Kampo medicine, in treating postoperative pain after tooth extraction with mandible bone removal. DESIGN This single-blind, randomized controlled study was conducted among two groups of adult patients who were scheduled to undergo tooth extraction with mandible bone removal under general anesthesia. Patients were randomly assigned to either the JDI or control group. INTERVENTION Before surgery, the JDI group received JDI (7.5 g), whereas the control group did not receive any treatment. Patients and the evaluator were blinded to the treatment status. At 0, 1, 3, and 24 h after anesthesia recovery, an investigator recorded the severity of postoperative pain and nausea using a numeric rating scale (0, no pain or nausea; 10, worst imaginable pain or nausea). The number of patients who requested nonsteroidal anti-inflammatory drug (NSAID) and that of additional NSAID administration within 24 h from anesthesia recovery, and the time to the first NSAID request from anesthesia recovery was also measured. RESULTS The severity of postoperative pain was significantly lower in the JDI group compared with the control group at 3 and 24 h after anesthesia recovery (p < 0.001 each). Both the number of patients requesting NSAID and additional NSAID administration after anesthesia recovery were significantly smaller in the JDI group than in the control group (p = 0.006, p < 0.001). The time to first NSAID request from anesthesia recovery was significantly longer in the JDI group compared with control group (p < 0.001). The severity of nausea did not differ significantly between the groups. No significant side effects related to JDI were noted during the trial. CONCLUSIONS JDI administration before general anesthesia effectively decreased the severity of postoperative pain after anesthesia recovery in patients who underwent tooth extraction with mandible bone removal.
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Affiliation(s)
| | - Kayoko Yamamoto
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Yuichi Ito
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Michi Omori
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Takaaki Ueno
- 2 Department of Oral and Maxillofacial Reconstructive Surgery, Osaka Medical College, Osaka, Japan
| | - Toshiaki Minami
- 1 Department of Anesthesiology, Osaka Medical College, Osaka, Japan
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