title: Assessment of preemptive analgesia with ibuprofen coadministered or not with dexamethasone in third molar surgery: a randomized double-blind controlled clinical trial.
abstract: BACKGROUND
  There is no conclusive evidence from clinical trial studies regarding preemptive analgesic interventions. Clinical trials are necessary to evaluate the efficacy of preemptive analgesic interventions already demonstrated in animal studies. Thus, it is necessary to evaluate the analgesic effect of preoperative administration of ibuprofen alone or coadministered with dexamethasone after third molar surgery.
  
  
  METHODS
  A randomized, double-blind, and controlled clinical trial was conducted with 94 bilateral symmetrical third molar surgeries. Preemptive analgesic medication was randomly defined: ibuprofen or placebo and ibuprofen + dexamethasone or placebo was administered to patients who served as their own control (split mouth). The variables analyzed were postoperative pain through visual analog scale (VAS), total number of rescue analgesic (TNRA), and patient satisfaction. Data were analyzed with the Mann-Whitney test.
  
  
  RESULTS
  There was no significant difference (p > 0.05) between ibuprofen and placebo for postoperative pain (VAS) and TNRA. Patients consumed less analgesics (TNRA) for dexamethasone + ibuprofen (p < 0.05) and felt more comfortable in the postoperative period after surgery (p < 0.05).
  
  
  CONCLUSIONS
  The preemptive analgesia with ibuprofen was insufficient to inhibit central sensitization, whereas its association with dexamethasone was more effective in preventing pain in third molar surgery.
authors.affiliation: Department of Stomatology, Discipline of Integrated Dental Clinic, School of Dentistry, University of São Paulo, Brazil.
authors.forename: Henrique Camargo
authors.initials: HC
authors.lastname: Bauer
authors.forename: Fabio Lopes
authors.initials: FL
authors.lastname: Duarte
authors.forename: Anna Carolina Ratto Tempestini
authors.initials: AC
authors.lastname: Horliana
authors.forename: Isabel Peixoto
authors.initials: IP
authors.lastname: Tortamano
authors.forename: Flávio Eduardo Guillin
authors.initials: FE
authors.lastname: Perez
authors.forename: José Leonardo
authors.initials: JL
authors.lastname: Simone
authors.forename: Waldyr Antonio
authors.initials: WA
authors.lastname: Jorge
mesh_terms: D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008964:Molar, Third / Q000000981:diagnostic imaging*; D009061:Mouth Mucosa; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000517:prevention & control; D011292:Premedication; D011859:Radiography; D014081:Tooth Extraction / Q000379:methods*; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D007052:Ibuprofen