术前口服布洛芬对种植体植入术后疼痛影响的随机对照研究  被引量:1

Effect of preoperative oral ibuprofen on postoperative pain after dental implantation:a randomized controlled trial

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作  者:郜康 魏雪竺 赵彬 刘之光 杜聪林 王新[1] 王瑶[6] 刘长营[6] 唐德争[6] 张琪[7] 吴瑞卿 欧明明 李威[8] 程茜[8] 谢亦林[8] 马攀[6] 李钧[6] 王昊[7] 王左敏[8] 陈溯[1] 张伟[9] 周建 Gao Kang;Wei Xuezhu;Zhao Bin;Liu Zhiguang;Du Conglin;Wang Xin;Wang Yao;Liu Changying;Tang Dezheng;Zhang Qi;Wu Ruiqing;Ou Mingming;Li Wei;Cheng Qian;Xie Yilin;Ma Pan;Li Jun;Wang Hao;Wang Zuomin;Chen Su;Zhang Wei;Zhou Jian(Department of VIP Dental Service,Capital Medical University School of Stomatology,Beijing 100050,China;Department of Emergency and General Dentistry,Capital Medical University School of Stomatology,Beijing 100050,China;Department of Pharmacy,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Statistics Department,Pharmacology Base,Beijing Anzhen Hospital,Capital Medical University,Beijing 100011,China;Beijing Laboratory of Oral Health,Capital Medical University,Beijing 100069,China;Department of Implantology,Capital Medical University School of Stomatology,Beijing 100050,China;Department of Stomatology,Beijing TianTan Hospital,Capital Medical University,Beijing 100070,China;Department of Stomatology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区:[1]首都医科大学口腔医学院特诊特需科,北京100050 [2]首都医科大学口腔医学院急诊综合诊疗中心,北京100050 [3]中国医学科学院、北京协和医学院、北京协和医院药剂科,北京100730 [4]首都医科大学附属北京安贞医院药理基地统计部,北京100011 [5]首都医科大学口腔健康北京实验室,北京100069 [6]首都医科大学口腔医学院种植中心,北京100050 [7]首都医科大学附属北京天坛医院口腔科,北京100070 [8]首都医科大学附属北京朝阳医院口腔科,北京100020 [9]北京大学口腔医学院·口腔医院口腔颌面外科、国家口腔医学中心、国家口腔疾病临床医学研究中心、口腔生物材料和数字诊疗装备、国家工程研究中心、口腔数字医学北京市重点实验室,北京100081

出  处:《中华口腔医学杂志》2024年第8期777-783,共7页Chinese Journal of Stomatology

基  金:北京市属医院科研培育计划(PX2021056);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2023-JKCS-19)。

摘  要:目的评价术前口服布洛芬的超前镇痛方案对单枚后牙种植体植入术后疼痛的影响。方法采用多中心、随机、双盲、安慰剂平行对照的试验设计。按照纳排标准收集2022年4月至2024年4月于首都医科大学口腔医学院(40例)、首都医科大学附属北京天坛医院(22例)及首都医科大学附属北京朝阳医院(20例)就诊的要求植入种植体的患者。采用简单随机方法将患者按照1∶1的比例分配至布洛芬组和对照组,每组41例。布洛芬组与对照组分别于术前15 min口服300 mg布洛芬缓释胶囊和安慰剂,并在术后3 d内接受相同的镇痛方案。通过数字评定量表(NRS)统计患者术后30 min和4、6、8、24、48、72 h的疼痛评分,并记录术后4~6 d额外镇痛药使用量。结果研究共入组82例患者,失访脱落7例(对照组4例、布洛芬组3例),共计75例(对照组37例、布洛芬组38例)患者完成试验,患者均未发生恶心、呕吐等不良事件。布洛芬组患者术后4、6、8 h的疼痛评分[分别为1.0(0.0,2.0)、1.0(0.0,2.0)、1.5(0.0,3.0)分]均显著低于对照组[分别为2.0(1.0,3.0)、3.0(1.5,4.0)、2.0(1.0,4.0)分](Z=-1.99,P=0.047;Z=-3.01,P=0.003;Z=-2.10,P=0.036)。布洛芬组与对照组分别有18.4%(7/38)和27.0%(10/37)的患者于术后4~6 d额外服用镇痛药,两者额外服用镇痛药的患者比例差异无统计学意义(χ^(2)=0.79,P=0.373);对照组与布洛芬组术后额外用药量分别为[0.0(0.0,1.0)粒]与[0.0(0.0,0.0)粒],差异无统计学意义(Z=-0.78,P=0.439)。结论布洛芬超前镇痛可有效降低患者种植体植入术后疼痛程度,是一种安全有效的围手术期疼痛管理方案。Objective To evaluate the effect of preemptive analgesia with ibuprofen on postoperative pain following single posterior tooth implantation,aiming to provide a clinical reference for its application.Methods A multicenter,randomized,double-blind,placebo-controlled parallel-group trial was conducted.A total of 82 participants were included in the trial,meeting the eligibility criteria from April 2022 to April 2024 at the Capital Medical University School of Stomatology(40 cases),Beijing TianTan Hospital,Capital Medical University(22 cases),Beijing Chao-Yang Hospital,Capital Medical University(20 cases).Participants were randomly assigned in a 1∶1 ratio to either the ibuprofen group or the control group,with each group comprising 41 individuals.Participants in the ibuprofen group received 300 mg of sustained-release ibuprofen capsules orally 15 min before surgery,while the control group received a placebo.Both groups received the same postoperative analgesic regimen for 3 days.Pain scores were assessed using the numerical rating scale at 30 min,4 h,6 h,8 h,24 h,48 h,and 72 h postoperatively,and the additional use of analgesic medication was recorded from days 4 to 6 postoperatively.Results A total of 82 participants were initially enrolled in the study,with 7 dropouts(4 from the control group and 3 from the ibuprofen group),resulting in 75 participants(37 in the control group and 38 in the ibuprofen group)completing the trial.There were no reports of adverse events such as nausea or vomiting among the participants.The ibuprofen group exhibited significantly lower pain scores at 4 h,6 h and 8 h[1.0(0.0,2.0),1.0(0.0,2.0),1.5(0.0,3.0)]postoperatively compared to the control group 4 h,6 h and 8 h[2.0(1.0,3.0),3.0(1.5,4.0),2.0(1.0,4.0)](Z=-1.99,P=0.047;Z=-3.01,P=0.003;Z=-2.10,P=0.036).The proportions of patients requiring additional analgesic medication between days 4 and 6 post-surgery were 18.4%(7/38)in the ibuprofen group and 27.0%(10/37)in the control group,with no significant difference(χ^(2)=0.79,P=0.373).The me

关 键 词:镇痛 疼痛 超前镇痛 疼痛管理 布洛芬 种植体 植入 

分 类 号:R783.6[医药卫生—口腔医学]

 

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