Post-Surgical Pain Management in Oral Surgery

Abdul Wahed; Jahangir Hammad; Attal Khan; Zoina; Rahim Jan; Maqbool Alam

doi:10.70749/ijbr.v3i3.2469

Authors

Abdul Wahed Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.
Jahangir Hammad Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.
Attal Khan Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.
Zoina Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.
Rahim Jan Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.
Maqbool Alam Department of Oral & Maxillofacial Surgery, Bolan Medical Complex Hospital, Quetta, Balochistan, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i3.2469

Keywords:

Oral Surgery, Post-Operative Pain, Pain Management, NSAIDs, Acetaminophen, Opioids

Abstract

Background: An essential part of oral surgery is post-operative pain management, which affects patient satisfaction and recovery results in addition to patient comfort. This study examines post-operative pain management techniques that use both pharmaceutical and non-pharmacologic approaches, with a focus on patient outcomes, adverse effects, and overall effectiveness. Objective: to determine the most popular approaches and the variables affecting their choice, as well as to assess the efficacy and patient satisfaction of the different pain management strategies utilized following oral surgery. Methods: This six-month qualitative study was carried out at a Quetta tertiary care facility. Semi-structured interviews were conducted with a purposive sample of 100 patients who had oral surgery. Patient-reported experiences with pharmacologic (NSAIDs, acetaminophen, opioids) and non-pharmacologic (cold therapy, TENS, laser treatment, education) pain management techniques were evaluated using thematic content analysis. Results: The most commonly utilized analgesics were NSAIDs (72%) and acetaminophen (65%), with combination therapy being used for 54% of patients. The most popular non-pharmacologic approach was cold therapy (66%). The majority of patients (86%) said they were happy with the way their pain was managed. Although 55% of respondents reported no negative effects, common side effects included tiredness (19%) and stomach discomfort (22%). Conclusion: A multimodal strategy that includes patient-centered care is necessary for effective post-operative pain control in oral surgery. NSAIDs continue to be the most common analgesics, although non-pharmacologic approaches, despite their underutilization, have the potential to improve satisfaction and recovery. In order to maximize results and minimize risks, the study promotes a stronger focus on patient education, integrated pain management techniques, and customized treatment regimens.

Downloads

Download data is not yet available.

References

1. Garimella, V., & Cellini, C. (2013). Postoperative pain control. Clinics in Colon and Rectal Surgery, 26(03), 191-196.

https://doi.org/10.1055/s-0033-1351138

2. Dewinter, G., De Velde, M. V., Fieuws, S., D’Hoore, A., & Rex, S. (2014). Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: Study protocol for a prospective, randomized, double-blind controlled clinical trial. Trials, 15(1).

https://doi.org/10.1186/1745-6215-15-476

3. Peršec, J. (2019). Regional analgesia modalities in abdominal and lower limb surgery - Comparison of efficacy. Acta Clinica Croatica.

https://doi.org/10.20471/acc.2019.58.s1.15

4. Cheung, C. (2017). Oral Oxycodone for acute postoperative Pain:A review of clinical trials. Pain Physician, 2(20;2), sE33-sE52.

https://doi.org/10.36076/ppj.2017.se52

5. Tan, M., Law, L. S., & Gan, T. J. (2014). Optimizing pain management to facilitate Enhanced Recovery After Surgery pathways. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 62(2), 203-218.

https://doi.org/10.1007/s12630-014-0275-x

6. Simpson, J., Bao, X., & Agarwala, A. (2019). Pain management in Enhanced Recovery After Surgery (ERAS) protocols. Clinics in Colon and Rectal Surgery, 32(02), 121-128.

https://doi.org/10.1055/s-0038-1676477

7. International association for the study of pain.

8. McKay, G. A., Walters, M. R., & Ritchie, N. D. (Eds.). (2020). Clinical pharmacology and therapeutics. John Wiley & Sons.

9. Bäckryd, E. (2018). Pain as the perception of someone: An analysis of the interface between pain medicine and philosophy. Health Care Analysis, 27(1), 13-25.

https://doi.org/10.1007/s10728-018-0359-9

10. Carr, E. C., & Thomas, V. J. (1997). Anticipating and experiencing post-operative pain: The patients' perspective. Journal of Clinical Nursing, 6(3), 191-201.

https://doi.org/10.1046/j.1365-2702.1997.00082.x

11. Patel, V., Gleeson, C. F., Kwok, J., & Sproat, C. (2013). Coronectomy practice. Paper 2: Complications and long term management. British Journal of Oral and Maxillofacial Surgery, 51(4), 347-352.

https://doi.org/10.1016/j.bjoms.2012.06.008

12. Renton, T. (2006). A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. BR J oral Maxillofac Surg 2005;43:7–12. British Journal of Oral and Maxillofacial Surgery, 44(1), 76-77.

https://doi.org/10.1016/j.bjoms.2005.03.031

13. Cervera-Espert, J., Perez-Martinez, S., Cervera-Ballester, J., Penarrocha-Oltra, D., & Penarrocha-Diago, M. (2016). Coronectomy of impacted mandibular third molars: A meta-analysis and systematic review of the literature. Medicina Oral Patología Oral y Cirugia Bucal.

https://doi.org/10.4317/medoral.21074

14. Moore, R. A. (2003). Bandolier's little book of pain. Oxford University Press.

15. Bromley, L., & Brandner, B. (Eds.). (2010). Acute pain. Oxford University Press.

16. Moore, R. A., Derry, S., Aldington, D., & Wiffen, P. J. (2015). Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database of Systematic Reviews.

https://doi.org/10.1002/14651858.cd008659.pub3

17. Cooper, S. A., & Beaver, W. T. (1976). A model to evaluate mild analgesics in oral surgery outpatients. Clinical Pharmacology & Therapeutics, 20(2), 241-250.

https://doi.org/10.1002/cpt1976202241

18. Urquhart, E. (1994). Analgesic agents and strategies in the dental pain model. Journal of Dentistry, 22(6), 336-341.

https://doi.org/10.1016/0300-5712(94)90084-1

19. Renton, T., & Yilmaz, Z. (2012). Managing iatrogenic trigeminal nerve injury: A case series and review of the literature. International Journal of Oral and Maxillofacial Surgery, 41(5), 629-637.

https://doi.org/10.1016/j.ijom.2011.11.002

20. Ong, C. K., Seymour, R. A., Lirk, P., & Merry, A. F. (2010). Combining paracetamol (Acetaminophen) with nonsteroidal antiinflammatory drugs. Anesthesia & Analgesia, 110(4), 1170-1179.

https://doi.org/10.1213/ane.0b013e3181cf9281

21. Daniels, S. E., Goulder, M. A., Aspley, S., & Reader, S. (2011). A randomised, five-parallel-group, placebo-controlled trial comparing the efficacy and tolerability of analgesic combinations including a novel single-tablet combination of ibuprofen/paracetamol for postoperative dental pain. Pain, 152(3), 632-642.

https://doi.org/10.1016/j.pain.2010.12.012

22. Moore, P. A., & Hersh, E. V. (2013). Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions. The Journal of the American Dental Association, 144(8), 898-908.

https://doi.org/10.14219/jada.archive.2013.0207

23. Kehlet, H., & Dahl, J. B. (1993). The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesthesia & Analgesia, 77(5), 1048???1056.

https://doi.org/10.1213/00000539-199311000-00030

24. Malamed, S. F. (2019). Handbook of Local Anesthesia (7th ed.). Elsevier Health Sciences.

25. Lieblich, S. E., & Danesi, H. (2017). Liposomal bupivacaine for management of postsurgical pain. Dental Clinics of North America, 61(4), 775–784.

26. Ong, C. K., Lirk, P., Seymour, R. A., & Jenkins, B. J. (2005). The efficacy of preemptive analgesia for acute postoperative pain management: A meta-analysis. Anesthesia & Analgesia, 100(3), 757-773.

https://doi.org/10.1213/01.ane.0000144428.98767.0e

27. Rana, M., Gellrich, N. C., & Chaushu, G. (2015). Non-pharmacological management of postoperative pain in maxillofacial surgery. International Journal of Oral and Maxillofacial Surgery, 44(5), 569–578.

28. Yamaguchi, T., Sato, D., & Takayama, Y. (2014). Psychological intervention in the management of postoperative dental pain: a review. Pain Research and Management, 19(6), 313–318.

29. Kaur, H., Sood, R., & Sharma, S. (2021). Personalized pain management in dentistry: a review. Journal of Clinical and Diagnostic Research, 15(5), ZE01–ZE05.