Citation Information :
Virda M, Panda A, Kataria K. Effect of Preemptive Analgesia on Pain Perception in Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024; 17 (8):913-917.
Background: Efforts have been made to minimize pain, prevent the development of needle fear, and promote positive experiences for children. The present study is designed to evaluate the effect of premedication with Ibugesic Plus before the administration of local anesthesia and extraction in children.
Aim: The aim of the study is to assess the efficacy of preemptive analgesia on pain perception during local anesthesia administration and extraction in pediatric patients.
Materials and methods: A total of 104 patients aged 7–10 years were selected who needed primary molar extraction. Group I—Ibugesic Plus syrup was given 30 minutes prior to extraction. Group II—Placebo solution (B-Folcin syrup) was given 30 minutes prior to extraction. Pain level, pulse rate, and SpO2 were assessed using the Wong–Baker Faces Pain Rating Scale (WBFS) and pulse oximeter after injection, after extraction, and postoperatively.
Results: The highest scores of pain were recorded after the time of injection and extraction. The patients who received preemptive analgesics (group I) reported significantly less pain than the placebo group (group II) at the time immediately after injection, after extraction, and 2 hours after extraction.
Conclusion: The present study showed that preemptive analgesic administration may be considered a routine and rational pain management strategy in primary tooth extraction procedures in children.
Clinical significance: Preemptive analgesia can be given to patients prior to dental procedures to reduce postoperative pain.
McWhorter AG, Townsend JA. American Academy of Pediatric Dentistry Symposium., Behavior symposium workshop a report – current guidelines/revision. Pediatr Dent 2014;36(2):152–153.
Rosero EB, Joshi GP. Preemptive, preventive, multimodal analgesia: what do they really mean? Plast Reconstr Surg 2014;134:85S–93S. DOI: 10.1097/PRS.0000000000000671
Ong CKS, Seymour RA, Chen FG, et al. Preoperative ketorolac has a preemptive effect for postoperative third molar surgical pain. Int J Oral Maxillofac Surg 2004;33(8):771–776. DOI: 10.1016/j.ijom.2004.01.020
Pektas ZO, Sener M, Bayram B, et al. A comparison of pre-emptive analgesic efficacy of diflunisal and lornoxicam for postoperative pain management: a prospective, randomized, single-blind, crossover study. Int J Oral Maxillofac Surg 2007;36(2):123–127. DOI: 10.1016/j.ijom.2006.10.005
Moore PA, Acs G, Hargreaves JA. Postextraction pain relief in children: a clinical trial of liquid analgesics. Int J Clin Pharmacol Ther Toxicol 1985;23(11):573–577.
Pozos-Guillen A, Martinez-Rider R, Aguirre-Banuelos P, et al. Pre-emptive analgesic effect of tramadol after mandibular third molar extraction: a pilot study. J Oral Maxillofac Surg 2007;65(7):1315–1320. DOI: 10.1016/j.joms.2006.10.079
Bjørnsson GA, Haanaes HR, Skoglund LA. A randomized, double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery. Br J Clin Pharmacol 2003;55:405–412. DOI: 10.1046/j.1365-2125.2003.01779.x
Dionne RA, Cooper SA. Evaluation of preoperative ibuprofen for postoperative pain after removal of third molars. Oral Surg Oral Med Oral Pathol 1978;45(6):851–856. DOI: 10.1016/s0030-4220(78)80004-8
Primosch RE, Antony SJ, Courts FJ. The efficacy of preoperative analgesic administration for postoperative pain management of pediatric dental patients. Anesth Pain Control Dent 1993;2(2):102–106.
Primosch RE, Nichols DL, Courts FJ. Comparison of preoperative ibuprofen, acetaminophen, and placebo administration on the parental report of postextraction pain in children. Pediatr Dent 1995;17(3):187–191.
Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatrics 1988;81(6):978–981.
Motoc D, Turtoi NC, Vasca V, et al. Physiology of pain – general mechanisms and individual differences. J Med Ar 2010;13:19–23.
Forbes JA, Kehm CJ, Grodin CD, et al. Evaluation of ketorolac, ibuprofen, acetaminophen, and an acetaminophen-codeine combination in postoperative oral surgery pain. Pharmacotherapy 1990;10(Suppl 6 Pt 2):94s–105s.
Santos PS, Massignan C, de Oliveira EV, et al. Does the pre-emptive administration of paracetamol or ibuprofen reduce transand post-operative pain in primary molar extraction? A randomized placebo-controlled clinical trial. Int J Paediatr Dent 2020;30(6):782–790. DOI: 10.1111/ipd.12649
Kharouba J, Ratson T, Somri M, et al. Preemptive analgesia by paracetamol, ibuprofen or placebo in pediatric dental care: a randomized controlled study. J Clin Pediatr Dent 2019;43(1):51–55. DOI: 10.17796/1053-4625-43.1.10
Baygin O, Tuzuner T, Isik B, et al. Comparison of pre-emptive ibuprofen, paracetamol, and placebo administration in reducing post-operative pain in primary tooth extraction. Int J Paediatr Dent 2011;21(4):306–313. DOI: 10.1111/j.1365-263X.2011.01124.x
O'Donnell A, Henderson M, Fearne J, et al. Management of postoperative pain in children following extractions of primary teeth under general anaesthesia: a comparison of paracetamol, voltarol and no analgesia. Int J Paediatr Dent 2007;17(2):110–115. DOI: 10.1111/j.1365-263X.2006.00800.x
Kharouba J, Hawash N, Peretz B, et al. Effect of intravenous paracetamol as pre-emptive compared to preventive analgesia in a pediatric dental setting: a prospective randomized study. Int J Paediatr Dent 2018;28(1):83–91. DOI: 10.1111/ipd.12311
