Preoperative versus postoperative pethidine for extraction of impacted third molars.
We have studied the pre-emptive analgesic effects of pethidine by comparing its analgesic effects given before or immediately after operation in a randomized, double-blind study of 40 patients undergoing removal of bilateral impacted third molars under general anaesthesia. Group 1 patients received pethidine 50 mg as a 1 ml injection 1 to 2 hours before operation and normal saline 1 ml intramuscularly immediately after surgery. Group 2 patients received normal saline 1 ml intramuscularly before operation and pethidine 50 mg as a 1 ml injection immediately after surgery. Outcome measures included perception of pain on a visual analogue scale (VAS), the number of patients who required postoperative pethidine, time to first postoperative pethidine injection and total dose of pethidine given. Four patients in group 1 compared to 8 in group 2 required postoperative pethidine but this was not statistically significant. The VAS scores, time to first postoperative pethidine injection and total dose of pethidine also did not differ significantly between the 2 groups. We concluded that preoperative administration of pethidine intramuscularly did not confer additional analgesic effects compared with a similar dose given after surgery.
Chew
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Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore.
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D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D011300:Preoperative Care; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D008614:Meperidine