Objective: The aim of this study was to compare preemptive analgesia of oral ketorolac plus submucous local placebo with oral ketorolac plus submucous local tramadol after impacted mandibular third molar surgery.
Study Design: A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were randomized into two treatment groups (n = 15 per group): group A, oral ketorolac 10 mg, 30 minutes before surgery plus submucous local placebo (1 mL saline solution); group B, oral ketorolac 10 mg, 30 minutes before surgery plus submucous local tramadol (50 mg diluted in 1 mL saline solution). We evaluated the intensity of pain, time for the first analgesic rescue medication, and total analgesic consumption.
Results: Pain intensity, number of patients requiring analgesic rescue medication, number of patients in each group not requiring analgesic rescue medication, and total analgesic consumption showed statistical significance.
Conclusions: Preemptive use of oral ketorolac plus submucous local tramadol is an alternative treatment for acute pain after surgical removal of an impacted mandibular third molar.
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http://dx.doi.org/10.4317/medoral.16854 | DOI Listing |
Open Access Emerg Med
December 2024
Department of Emergency Medicine, Northwell, New Hyde Park, NY, USA.
Purpose: We describe emergency medical services (EMS) protocols for pain management in the United States to elucidate systemic variability in protocols. We describe types of pain medications included in protocols, routes of administration, indications for use, standing orders for dosing, and use in pediatric patients.
Methods: We performed a review of all publicly accessible EMS protocols from the website http://www.
Pain Physician
December 2024
Departments of Anesthesia, Intensive Care, and Pain Management, Faculty of Human Medicine, Zagazig University Alsharkia, Egypt.
Background: Post dural puncture headache (PDPH) is a major challenging complication and may be a cause of morbidity after spinal anesthesia. Currently there is no definitive management for PDPH, so the search for effective treatment continues.
Objectives: Our aim was to investigate the analgesic effectiveness of oral prednisolone vs oral pregabalin for managing PDPH subsequent to spinal anesthesia for lower limb surgeries.
Spine J
December 2024
Department of Neurosurgery, Baylor Scott and White Health, Temple, TX, 76508, USA; School of Medicine, Baylor College of Medicine, Temple, TX, 76508, USA.
Background Context: Ropivacaine-Epinephrine-Clonidine-Ketorolac (RECK) cocktail can improve pain control in patients undergoing lumbar decompression. Given the aging population, rising healthcare costs, the opioid epidemic, and associations of acute pain control with long-term opioid use, effective opioid-sparing analgesia following spinal fusion surgery may impart societal benefits.
Purpose: We aimed to investigate whether RECK was an effective local anesthetic for patients undergoing posterior spinal fusion.
Pharmacol Res Perspect
December 2024
Health Sciences Center, Stomatology Department, Autonomous University of Aguascalientes, Aguascalientes, Mexico.
The primary objective of the present review was to report the safety profile of oral ketorolac in adults using the systematic review and meta-analysis methodology based on clinical trials. The present study is a PRISMA-based systematic review and risk ratio (RR) meta-analysis of the adverse events reported in clinical trials that used oral ketorolac; the review includes 50 clinical trials. The RR for the comparison of a single intake of oral ketorolac versus placebo, including all types of adverse events, was RR = 2.
View Article and Find Full Text PDFAm J Obstet Gynecol MFM
November 2024
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA. Electronic address:
The following review focuses on routine postoperative care after cesarean delivery (CD), including specific Enhanced Recovery After Cesarean (ERAS) recommendations as well as important postpartum counseling points. Following CD, there is insufficient evidence to support administration of prophylactic multi-dose antibiotics to all patients. Additional antibiotic doses are indicated for the following scenarios: patients with obesity, CD lasting ≥ 4 hours since prophylactic dose, blood loss >1,500 mL, or those with an intra-amniotic infection.
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