Protocolos de medicação pré e pós-operatória para cobertura radicular combinada com enxerto de tecido conjuntivo.

This trial evaluated the preemptive and postoperative effect of dexamethasone and ibuprofen on prevention of pain/discomfort, edema and interference in daily life in patients undergoing root coverage combined with subepithelial connective tissue graft (CAF + CTG). Twenty patients were randomly assigned as follows: NSAID Group: 400mg Ibuprofen 60 min preemptive + 400mg Ibuprofen postoperative; or SAID Group: 4mg Dexamethasone 60 min preemptive + 4mg Dexamethasone postoperative. The postoperative medication was administered 8 and 16 h post-surgery. Each patient received questionnaires based on a numeric scale (101-point numeric scale rate [NRS-101]) and multiple choice questions (four-point verbal rating scale [VRS-4]) about trans-operative pain/discomfort, hourly for 8 h after surgery and once a day for three days. A Visual Analogue Scale (VAS) for edema and interference in daily life during the 1st, 2nd, 3rd and 7th day was also answered. The degree of anxiety was rated statistically by the Chi-square test. The Mann-Whitney and Friedman tests were used for the other questionnaires. The surgery time and number of analgesic pills consumed were compared using Student’s t-test. Patients who used dexamethasone presented a trend toward less pain when compared to individuals who ingested ibuprofen, with a significant difference observed 3 h after the procedure (p<0.05). The use of dexamethasone also promoted less edema until the 2nd day and lower interference in daily life on the third day when compared with ibuprofen (p<0.05). We concluded that the use of dexamethasone as a preemptive and postoperative medication was more suitable as a drug therapeutic protocol for CAF + CTG.Este estudo avaliou o efeito pré e pós-operatório de dexametasona e ibuprofeno na prevenção de dor / desconforto, edema e interferência na vida diária em pacientes submetidos à cobertura radicular combinada com enxerto de tecido conjuntivo subepitelial (CAF + CTG). Vinte pacientes foram aleatoriamente designados da seguinte forma: Grupo AINE: 400mg de ibuprofeno 60 min preemptivo + 400mg de ibuprofeno no pós-operatório; ou Grupo SAID: 4mg de dexametasona 60 min preemptiva + 4mg de dexametasona pós-operatória. A medicação pós-operatória foi administrada 8 e 16 horas após a cirurgia. Cada paciente recebeu questionários com base em uma escala numérica (escala numérica de 101 pontos [NRS-101]) e questões de múltipla escolha (escala de avaliação verbal de quatro pontos [VRS-4]) sobre dor / desconforto transoperatório, de hora em hora para 8 h após a cirurgia e uma vez por dia durante três dias. Também foi respondida a Escala Visual Analógica (EVA) para edema e interferência na vida diária durante o 1º, 2º, 3º e 7º dia. O grau de ansiedade foi avaliado estatisticamente pelo teste Qui-quadrado. Os testes de Mann-Whitney e Friedman foram usados ​​para os demais questionários. O tempo de cirurgia e o número de comprimidos analgésicos consumidos foram comparados usando o teste t de Student. Pacientes que fizeram uso de dexametasona apresentaram tendência a menos dor quando comparados aos indivíduos que ingeriram ibuprofeno, com diferença significativa observada três horas após o procedimento (p <0,05). O uso de dexametasona também promoveu menos edema até o 2º dia e menor interferência na vida diária no terceiro dia quando comparado ao ibuprofeno (p <0,05)

Preemptive and Postoperative Medication Protocols for Root Coverage Combined with Connective Tissue Graft

<div><p>Abstract This trial evaluated the preemptive and postoperative effect of dexamethasone and ibuprofen on prevention of pain/discomfort, edema and interference in daily life in patients undergoing root coverage combined with subepithelial connective tissue graft (CAF + CTG). Twenty patients were randomly assigned as follows: NSAID Group: 400mg Ibuprofen 60 min preemptive + 400mg Ibuprofen postoperative; or SAID Group: 4mg Dexamethasone 60 min preemptive + 4mg Dexamethasone postoperative. The postoperative medication was administered 8 and 16 h post-surgery. Each patient received questionnaires based on a numeric scale (101-point numeric scale rate [NRS-101]) and multiple choice questions (four-point verbal rating scale [VRS-4]) about trans-operative pain/discomfort, hourly for 8 h after surgery and once a day for three days. A Visual Analogue Scale (VAS) for edema and interference in daily life during the 1st, 2nd, 3rd and 7th day was also answered. The degree of anxiety was rated statistically by the Chi-square test. The Mann-Whitney and Friedman tests were used for the other questionnaires. The surgery time and number of analgesic pills consumed were compared using Student’s t-test. Patients who used dexamethasone presented a trend toward less pain when compared to individuals who ingested ibuprofen, with a significant difference observed 3 h after the procedure (p<0.05). The use of dexamethasone also promoted less edema until the 2nd day and lower interference in daily life on the third day when compared with ibuprofen (p<0.05). We concluded that the use of dexamethasone as a preemptive and postoperative medication was more suitable as a drug therapeutic protocol for CAF + CTG.</p></div