Publication: Eficacia de la cronoterapia sobre la inflamación y el dolor postoperatorio de la cirugía del tercer molar inferior. Un estudio piloto.
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2021
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Abstract
Introducción:El postoperatorio de la extracción del tercer molar inferior se caracteriza por la presencia de inflamación, dolor y trismo prescribiéndose anti-inflamatorios no esteroideos(AINEs) de forma rutinaria para disminuir los síntomas. La cronoterapia se basa en administrar los fármacos coordinados con los ritmos circadianos del cuerpo humano.
Material y método:Se realizó un ensayo clínico a boca partida en el que se pautó ibuprofeno 400mg cada ocho horas en el grupo control e ibuprofeno 400mg en desayuno y comida, junto a un placebo por la noche en el grupo experimental. Se obtuvieron muestras sanguíneas pre operatorias y a las 72 horas para el análisis de los marcadores inflamatorios, además del registro de variables clínicas post operatorias.
Resultados: La evaluación de la inflamación y el trismo no arrojó diferencias significativas entre los dos grupos de estudio a las 24 y 72 horas. En cuanto al dolor, no presentó diferencias estadísticamente significativas entre ambos grupos a las 24, 48 ni 72 horas. El dolor si se mostró más intenso por la mañana, de manera estadísticamente
significativa, en el grupo experimental frente al control (p= 0.04) El empleo de analgesia de rescate también fue significativo en el grupo control (0 sujetos) frente al grupo experimental (2 sujetos) (p=0.026). La evaluación de las muestras sanguíneas se encuentra actualmente en procesamiento.
Conclusiones:A falta de los resultados de las muestras sanguíneas, la administración del ibuprofeno coordinado con los ritmos circadianos no ha demostrado ser peor a la pauta habitual en el post operatorio del tercer molar.
Introduction:The lower third molar extraction post operatory is characterized by swelling, pain and trismus, prescribing Non-Steroidal Anti-Inflammatories (NSAID) routinely. Chronotherapy is based on the coordinated administration of drugs with the circadian rhythms.Material and Method:A splith mouth randomized clinical trial was done prescribing ibuprofen 400 mg each eight-hours in the control group while the experimental group received the medication at breakfast and lunch, and placebo was administered at dinner. Blood samples were collected pre operatory and 72 hours after the surgery for the inflammatory markers,moreover the post-operative clinical variables.Resultados:Swelling and trismus did not show significative difference between the control and experimental group at 24 and 72 hours. Regarding the pain there was no difference among the groups at 24,48 or 72-hours. Pain sensivity was more intense during the morning in the experimental group (p=0.04). The rescue analgesia has statistical differences between the groups (p=0.026) with two patients needing in the control group.The blood samples collected are being processed in the laboratory at the moment.Conclusion:Despite the analysis of the results is incomplete, the used of ibuprofen mediated by chronotherapy has shown similar results to the classical dosage in the third molar post operatory.
Introduction:The lower third molar extraction post operatory is characterized by swelling, pain and trismus, prescribing Non-Steroidal Anti-Inflammatories (NSAID) routinely. Chronotherapy is based on the coordinated administration of drugs with the circadian rhythms.Material and Method:A splith mouth randomized clinical trial was done prescribing ibuprofen 400 mg each eight-hours in the control group while the experimental group received the medication at breakfast and lunch, and placebo was administered at dinner. Blood samples were collected pre operatory and 72 hours after the surgery for the inflammatory markers,moreover the post-operative clinical variables.Resultados:Swelling and trismus did not show significative difference between the control and experimental group at 24 and 72 hours. Regarding the pain there was no difference among the groups at 24,48 or 72-hours. Pain sensivity was more intense during the morning in the experimental group (p=0.04). The rescue analgesia has statistical differences between the groups (p=0.026) with two patients needing in the control group.The blood samples collected are being processed in the laboratory at the moment.Conclusion:Despite the analysis of the results is incomplete, the used of ibuprofen mediated by chronotherapy has shown similar results to the classical dosage in the third molar post operatory.
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