Essay Example on The significant concern for surgeon and Anaesthesiologist









The significant concern for surgeon and anaesthesiologist is the efficient postoperative pain management Kara et al 2010 18 Around patients of 80 of them underwent surgical procedures experience mild to severe pain in postoperative Galani et al 2013 19 This study investigated the clinical efficacy of managing postoperative pain using the Aceclofenac and Piroxicam after third molar surgery The main reason for doing this present study as there are a lot of researchers have carried out the studies in light of pre and post treatment orally or intravenously administered analgesics However comparative studies with respect to analgesic efficacy for preventing postoperative pain after third molar surgery was limited To our knowledge the comparison perspective of the two compounds like Aceclofenac and Piroxicam was not used in many studies Hence the present study attempts to fill the gap by comparing the analgesic effect of two compounds as pre emptive analgesic for preventing postoperative pain after third molar surgery Analgesic treatment is commonly used and well accepted procedure for examining anti inflammatory and anaesthetics Tuzuner Oncul et al 2011 20 Avelar et al 2012 21 de Sousa Santos et al 2012 22 Trindade et al 2012 23 Bauer et al 2013 24 Aceclofenac and Piroxicam were the common prescribed agents for different patients in few European and Asian countries Lemmel et al 2002 25 Kumar et al 2013 26 Both compounds are non steroidal anti inflammatory drug NSAID which is commonly used for relief of inflammation and pain in ankylosing spondylitis osteoarthritis and rheumatoid arthritis 

However, both the compounds have some side effects for Aceclofenac has the symptoms of hypotension fainting dizziness occasionally convulsions respiratory depression and tinnitus While for Piroxicam ringing in ears headache skin itching or rash disorientation upset stomach etc These two compounds act as the non selective COX inhibitor possessing both antipyretic and analgesic properties The biological half life of Piroxicam is around 50 hours while for Aceclofenac is 4 hours only EMC 2017 27 VAS was used in this study to measure the pain experience of patients who underwent third molar surgery When patients obtained no medication of analgesics they reported the pain score of 8 on VAS of 247 scale from 0 to 10 10 notice the worst pain and 0 presents no pain Nørholt 1998 28 It is noticed that pain in after removal of third molars is of short duration and attain the maximum intensity in the post operative period Chitlangia et al 2013 29 The experience of pain is useful especially for examining the single doses of analgesics efficacy Numerous clinical researches with respect to pre emptive analgesia value were carried out as per the dosing routes drug types and administrating times Chitlangia et al 2013 29 Meechan and Seymour 1993 30 Campbell Kendrick and JP 1998 31 The study findings did not receive significant difference in pain experience among both groups A and B in post operative period who underwent surgery via Mann Whitney Test However study observes high significant difference in both groups in terms of pain intensity scores at the different time points in Freidman test This was in line with the study of Chunduri et al 2013 32 shows the efficacy of diclofenac and aceclofenac for the relief of postoperative pain after third molar surgery that shows the epigastric pain and nausea was high in diclofenac group than aceclofenac 

Results shows that there was a significant difference in before and 24 hours before and 3rd day before and 5th days 24 hours and 5th day and 3rd and 5th day Further study shows that the effectiveness of the drug was not shown in 24 hours to 3rd day In addition the study results shows that there was a significant difference in before and 24 hours before and 3rd day and 24 hours and 5th day and 3rd and 5th day It was observed in both groups shows significant difference in Trismus 5th day and Trismus 3rd day Overall both the groups experienced post operative pain experience However the compounds of Aceclofenac and Piroxicam are well tolerated to the patients When compared to Aceclofenac Piroxicam is effective for patients in third molar surgery It was consistent with the study of Torri et al 1994 33 Busquier et al 1997 34 The therapeutic efficacy recommends that Piroxicam is a well tolerated alternative NSAID one than Aceclofenac in the treatment of third molar surgery Conclusion The third molar is the most common oral surgical procedure that gives moderate to severe postoperative pain Better pain management enhance the quality of life after procedure However preemptive analgesia may be effective in decreasing pain intensity This comparative research of pain intensity shows after pre emptive analgesia with Aceclofenac and Piroxicam in impaction of third molars demonstrated a pronounced preemptive effect in the group treated with Piroxicam 20mg thus there was no significant difference noted in VAS Before and 5th day of both groups

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