Effect of vasoconstriction on pain after mandibular third molar surgery: A single-blind, randomized controlled trial.
OBJECTIVE
Previous research has demonstrated the efficacy of using local compression to reduce postoperative pain after third molar surgery. It has been theorized that compression reduces pain intensity through vasoconstriction. The current research tests the veracity of this vasoconstriction hypothesis by testing the impact of local epinephrine (a local vasoconstrictor) versus a control on patients' pain ratings over 7 days following surgery.


METHODS
Fifty patients scheduled for mandibular third molar surgery were randomly assigned to receive one cartridge of Ultracaine DS Forte (the treatment group) or one cartridge of Ultracaine DS (the control group) after surgical removal of the third molar. Participants used the visual analog scale (VAS) to provide daily ratings of pain intensity for 7 days following surgery. In addition, on day 7, the perceived effectiveness of the pain treatment was measured with the global perceived effect (GPE) scale. A quality- of-life questionnaire was also completed.


RESULTS
A repeated-measures ANOVA indicated that the treatment group perceived significantly less pain than the control group on days 2 to 7 following surgery. In addition, 77.8% of the treatment group perceived their pain treatment to be successful, while only 69.6% of the control group reported that their pain was reduced successfully by day 7.


CONCLUSIONS
The results of this study provide an initial proof of concept that epinephrine may have an analgesic effect on the period following third molar surgery. Further research with larger sample sizes is needed to strengthen evidence for the clinical utility of offering localized epinephrine to patients following third molar surgery.
Wilhelmus J J M
WJ
Martin
Nynke E
NE
Skorpil
Claire E
CE
Ashton-James
D Bram
DB
Tuinzing
Tymour
T
Forouzanfar
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002355:Carticaine / Q000627:therapeutic use*; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method; D014081:Tooth Extraction; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D004837:Epinephrine