Abstract
The aim of this pilot study was to evaluate pre-emptive analgesia using the combination
tramadol plus meloxicam compared with each individual drug alone for the reduction
of pain after extraction of third molars. Fifty-one patients were randomised into
three groups (n = 17 in each), using a series of random numbers: the first group was given tramadol
25 mg and meloxicam 7.5 mg; the second tramadol 50 mg, and the third meloxicam 15 mg, all intramuscularly. Treatments were prepared in identical syringes by an independent
investigator and were given immediately. The teeth were removed 50 min after the analgesics had been given. Intensity of pain, consumption of analgesics,
and adverse effects were evaluated. The intensity of pain was evaluated using a visual
analogue scale (VAS) and the area under the curve of the VAS showed significant differences
amongst the groups. In conclusion, the study showed that the combination of tramadol
25 mg and meloxicam 7.5 mg had an analgesic effect similar to that of meloxicam 15 mg, but both were better than tramadol 50 mg for relief of pain after the extraction of mandibular third molars.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Suppression of postoperative pain by preoperative administration of ibuprofen in comparison to placebo, acetaminophen, and acetaminophen plus codeine.J Clin Pharmacol. 1983; 23: 37-43
- Complementary and synergistic antinociceptive interaction between the enantiomers of tramadol.J Pharmacol Exp Ther. 1993; 267: 331-340
- Double blind comparison of the morphine sparing effect of continuous and intermittent i.m administration of ketorolac.Br J Anaesth. 1991; 67: 235-238
- The value of “multimodal” or “balanced analgesia” in postoperative pain treatment.Anesth Analg. 1993; 77: 1048-1056
- Double blind controlled trial of indomethacin as an adjuvant to narcotic analgesia after major abdominal surgery.Lancet. 1982; ii: 115-118
- Tramadol: a review of its use in perioperative pain.Drugs. 2000; 60: 139-176
- The efficacy of combination analgesic therapy in relieving dental pain.J Am Dent Assoc. 2002; 133: 861-871
- Meloxicam: a review of its pharmacokinetics, efficacy and tolerability following intramuscular administration.Inflamm Res. 2001; 50: s5-s9
- Evaluation of meloxicam (A cox-2 inhibitor) for management of postoperative endodontic pain: a double-blind placebo-controlled study.J Endod. 2003; 29: 634-637
- Lack of effect of naltrexone on the spinal synergism between morphine and non steroidal anti-inflammatory drugs.Pharmacol Rep. 2009; 61: 268-274
- Preemptive analgesic effectiveness of oral ketorolac plus local tramadol after impacted mandibular third molar surgery.Med Oral Patol Oral Cir Bucal. 2011; 16: e776-e780
- Analysis of serial measurements in medical research.BMJ. 1990; 300: 230-235
Moore RA, Derry S, McQuay HJ. Single dose oral meloxicam for acute postoperative pain in adults. Cochrane Database Syst Rev. In: The Cochrane Library, Issue 04, Art. No. CD007552. DOI: 10.1002/14651858.CD007552.pub4.
- Premedication with cyclooxygenase-2 inhibitor meloxicam reduced postoperative pain in patients after oral surgery.Int J Oral Maxillofac Surg. 2006; 35: 613-617
- Analgesic and anti-inflammatory dose–response relationship of 7.5 and 15 mg meloxicam after lower third molar removal: a double-blind, randomized, crossover study.Int J Oral Maxillofac Surg. 2007; 36: 26-31
- Comparison of analgesic and anti-inflammatory efficacy of selective and non-selective cyclooxygenase-2 inhibitors in dental implant surgery.J Periodontol. 2007; 78: 2284-2288
- The effects of tramadol added to articaine on anesthesia duration.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: 614-617
- Tramadol administered in a combination of routes for reducing pain after removal of an impacted mandibular third molar.J Oral Maxillofac Surg. 2007; 65: 1633-1639
- Preoperative intravenous tramadol versus ketorolac for preventing postoperative pain after third molar surgery.Int J Oral Maxillofac Surg. 2004; 33: 274-278
- Patient-controlled analgesia with tramadol versus tramadol plus ketorolac.Minerva Anestesiol. 2006; 72: 59-67
- Patient-controlled analgesia with tramadol versus tramadol plus lysine acetyl salicylate.Anesth Analg. 2000; 91: 1226-1229
Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database Syst Rev. In: The Cochrane Library, Issue 03, Art. No. CD001547. DOI: 10.1002/14651858.CD001547.pub4.
Gaskell H, Derry S, Moore RA, McQuay HJ. Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults. Cochrane Database Syst Rev. In: The Cochrane Library, Issue 03, Art. No. CD002763. DOI: 10.1002/14651858.CD002763.pub4.
Moore RA, Collins S, Edwards J, Derry S, McQuay HJ. Single dose oral dextropropoxyphene, alone and with paracetamol (acetaminophen), for postoperative pain. Cochrane Database Syst Rev. In: The Cochrane Library, Issue 03, Art. No. CD001440. DOI: 10.1002/14651858.CD001440.pub4.
Article info
Publication history
Published online: January 06, 2012
Accepted:
December 8,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
