Influence of anesthetic solution on pain perception after periodontal surgery – a pilot study
Influência da solução anestésica na percepção de dor após cirurgia periodontal: um estudo piloto
Steffens, João Paulo; Santos, Fábio André; Pilatti, Gibson Luiz
Rev. odontol. UNESP, vol.38, n6, p.357-361, 2009
Resumo
As características farmacológicas de agentes anestésicos locais estão entre os diversos fatores que podem influenciar a percepção de dor pós-operatória. O objetivo deste estudo piloto foi avaliar a influência de dois agentes anestésicos na percepção de dor pós-operatória após cirurgia a retalho para raspagem e alisamento radicular (RAR). Neste ensaio clínico randomizado, paralelo, duplo-cego, foram realizadas 12 cirurgias para RAR em pacientes com doença periodontal que apresentassem sinais clínicos de inflamação após terapia periodontal básica em pelo menos um sextante. Os pacientes foram aleatoriamente alocados em um dos seguintes grupos: G1- mepivacaína 2% com norepinefrina 1:100.000; G2- lidocaína 2% com epinefrina 1:100.000. A intensidade da dor foi avaliada através de escala visual analógica (EVA) e escala numérica de 101 pontos (NRS-101) durante 8 horas após a cirurgia. Os resultados demonstraram que a intensidade de dor pós-operatória foi estatisticamente inferior no grupo G2 nos períodos de 1 (Mediana (Md) G1:2,5; G2:18; p=0,01), 2 (Md G1:2; G2:28,5; p=0,009) e 3 (Md G1:6; G2:28; p=0,01) horas após a cirurgia. Desta forma, os dados deste estudo piloto indicam que a utilização de mepivacaína 2% com norepinefrina 1:100.000 promove maior controle da dor no período pós-operatório imediato que a lidocaína 2% com epinefrina 1:100.000 após cirurgia de RAR a retalho.
Palavras-chave
Solução anestésica, dor pós-operatória, lidocaína, mepivacaína.
Abstract
Pharmacologic characteristics of local anesthetics agents are among several features that may influence postoperative pain intensity. The aim of this study was to evaluate the influence of two anesthetic agents on postoperative pain perception after open flap debridement surgeries. For this parallel-group, double-masked, placebo-controlled randomized clinical trial, 12 surgeries for open flap debridement were performed on patients who presented periodontal disease with clinical signs of inflammation after nonsurgical treatment on at least one sextant. Patients were allocated in one of the following groups: G1- 2% mepivacaine with 1:100.000 norepinephrine; G2- 2% lidocaine with 1:100.000 epinephrine. Pain intensity was assessed using visual analog scale (VAS) and 101-point numerical rate scale (NRS-101) during the first 8 hours after surgery. The results demonstrated that postoperative pain intensity was statistically lower in G2 at 1 (Median (Md) G1:2.5; G2:18; p = 0.01), 2 (Md G1:2; G2:28.5; p = 0.009) and 3 (Md G1:6; G2:28; p = 0.01) hours-period after surgery. Therefore, data from this pilot study indicate that 2% mepivacaine with 1:100.000 norepinephrine might promote more pain control at immediate postoperative period than does 2% lidocaine with 1:100.000 epinephrine after open flap debridement surgery.
Keywords
Anesthetic solution, pain postoperative, lidocaine, mepivacaine.
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