title: Effects of co-administered dexamethasone and nimesulide on pain, swelling, and trismus following third molar surgery: a randomized, triple-blind, controlled clinical trial.
abstract: This study aimed to determine the effect of the co-administration of dexamethasone 8mg and nimesulide 100mg given 1h before mandibular third molar surgery. A prospective, randomized, triple-blind, split-mouth clinical trial was developed at the study institution in Pernambuco, Brazil. A pilot study was first performed (95% confidence interval, 80% test power, and 5% error), and a sample of 40 patients aged between 18 and 40 years was selected. The patients were randomized and divided into two groups: dexamethasone+placebo and dexamethasone+nimesulide. The following parameters were evaluated: pain (visual analogue scale), total number of rescue analgesics taken, time taken to first rescue analgesic consumption, oedema, trismus, and patient satisfaction. The paired t-test and the Wilcoxon test were used to compare means. Statistically significant differences were found between the groups in pain values at 2, 4, and 12h postoperative, and in the total number of rescue analgesics and time taken to first rescue analgesic ingestion (P<0.05), with results in favour of dexamethasone+nimesulide administration. Oedema and trismus were similar in the two treatment groups and decreased over time postoperatively. The co-administration of dexamethasone and nimesulide reduces pain intensity and the need for rescue medication after third molar surgery.
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil. Electronic address: jimmybarbalho@hotmail.com.
authors.forename: J C
authors.initials: JC
authors.lastname: Barbalho
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil.
authors.forename: R J H
authors.initials: RJ
authors.lastname: Vasconcellos
authors.affiliation: Oral and Maxillofacial Department, State University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil.
authors.forename: H H
authors.initials: HH
authors.lastname: de Morais
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil.
authors.forename: L A M
authors.initials: LA
authors.lastname: Santos
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil.
authors.forename: R de A C
authors.initials: RA
authors.lastname: Almeida
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil.
authors.forename: H L
authors.initials: HL
authors.lastname: Rêbelo
authors.affiliation: Oral and Maxillofacial Department, State University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil.
authors.forename: E E
authors.initials: EE
authors.lastname: Lucena
authors.affiliation: Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Tabatinga, Camaragibe, Pernambuco, Brazil.
authors.forename: S Q
authors.initials: SQ
authors.lastname: de Araújo
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001938:Brazil; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004487:Edema / Q000517:prevention & control*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D013449:Sulfonamides / Q000008:administration & dosage*; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome; D014313:Trismus / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D013449:Sulfonamides; D003907:Dexamethasone; C012655:nimesulide
keywords: anti-inflammatory agents; oedema; pain; third molar; trismus