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Title: Preoperative ketorolac has a preemptive effect for postoperative third molar surgical pain
Authors: Ong, C.K.S.
Seymour, R.A.
Chen, F.G. 
Ho, V.C.L.
Keywords: Analgesic
Third molar surgery
Issue Date: 2004
Citation: Ong, C.K.S., Seymour, R.A., Chen, F.G., Ho, V.C.L. (2004). Preoperative ketorolac has a preemptive effect for postoperative third molar surgical pain. International Journal of Oral and Maxillofacial Surgery 33 (8) : 771-776. ScholarBank@NUS Repository.
Abstract: There is uncertainty regarding the role of preemptive analgesia in preventing postoperative pain. Most previous studies were of parallel design completed under general anesthesia with many confounding inter-patient's variables. The present study evaluated the efficacy of preemptive ketorolac in a crossover design in patients undergoing bilateral mandibular third molar surgery. This was a double blind, randomized, placebo-controlled study where 34 patients had each of their identical impacted mandibular third molars removed under local anesthesia on two occasions. Each patients acted as their own control; one side was pretreated with intravenous ketorolac 30 mg before surgery followed by placebo injection after surgery, and for the other side, the patient was given placebo injection before surgery and post-treated with intravenous ketorolac 30 mg after surgery. The difference in postoperative pain between pretreated and post-treated side in each patient was assessed by four primary end-points: pain intensity as measured by a 100-mm visual analogue scale hourly for 12 h, time to rescue analgesic, postoperative analgesic consumption, and patient's global assessment. Throughout the 12-h investigation period, patients reported significantly lower pain intensity scores in the ketorolac pretreated sides when compared with the post-treated sides (P=0.003). Patients also reported a significantly longer time to rescue analgesic (8.9 h versus 6.9 h, P=0.005), lesser postoperative analgesic consumption (P=0.007) and better global assessment for the ketorolac pretreated sides (P=0.01). Pretreatment with intravenous ketorolac has a preemptive effect for postoperative third molar surgery and extended the analgesia by approximately 2 h. © 2004 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Source Title: International Journal of Oral and Maxillofacial Surgery
ISSN: 09015027
DOI: 10.1016/j.ijom.2004.01.020
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