Volume 7, Issue 4 (10-2022)                   J Res Dent Maxillofac Sci 2022, 7(4): 241-248 | Back to browse issues page

Ethics code: A-10-893-1
Clinical trials code: 8963


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Khalili M, Farazmehr K, Shafaeefard S, Irani F. Effect of Paracetamol and Magnesium Sulfate on Level of Pain and Opioid Intake following Orthognathic Surgery: A Clinical Trial. J Res Dent Maxillofac Sci 2022; 7 (4) :241-248
URL: http://jrdms.dentaliau.ac.ir/article-1-372-en.html
1- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
2- Department of Anesthesiology and Critical Care, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
3- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran , Shahroozshafaeefard@gmail.com
4- Private Dentistry practice, Tehran, Iran
Abstract:   (173 Views)

Background and Aim: Considering the side effects of high doses of opioids taken postoperatively for pain control, paracetamol and magnesium sulfate may be able to aid in pain control. This study assessed the effects of paracetamol and magnesium sulfate on the level of pain and opioid intake following orthognathic surgery.   
Materials and Methods: In this double-blind randomized clinical trial, patients scheduled for bimaxillary orthognathic surgery were randomly assigned to two groups of 25. Group 1 patients received 1 g infusion of intravenous acetaminophen (paracetamol) administered within 20 minutes while group 2 patients received 50 mg/kg magnesium sulfate infusion one hour prior to completion of surgery. The patients were asked to express their level of pain prior to discharge from the recovery, and every 4 hours for 12 hours using a visual analog scale (VAS). Patients with pain score > 5 at any time received 30 mg pethidine. The total received dosage of pethidine postoperatively was recorded and those that received pethidine were not included in pain score analysis. Data were analyzed by generalized estimating equation (GEE), and Mann-Whitney U, Chi-square, and t-tests.
Results: The pain score was not significantly different between the two groups at the time of recovery and 4 and 8 hours (P>0.05). The magnesium sulfate group had significantly lower pain score at 12 hours (P=0.009). The difference in pethidine dosage was not significant (P>0.05).
Conclusion: Both magnesium sulfate and paracetamol decreased postoperative pain and the need for opioid consumption, but magnesium sulfate was slightly more effective.

Full-Text [PDF 715 kb]   (79 Downloads) |   |   Full-Text (HTML)  (48 Views)  

References
1. Shakeri M R, Derakhshan P, Sheykholvaezin F, Koleini Z. The comparison between postoperative analgesic effect of Morphine-Apotel and Ketorolac alone with intravenous patient control analgesia in patients candidate for plating surgery. JAP. 2016;7(2):1-8.
2. Sanjar Mousavi N, Khalili R. The effect of intravenous injection of Acetaminophen (Apothec) on pain relief after abdominoplasty. Journal of Islamic Azad University Mashhad Branch. 2014; 4(1):1-17.
3. Atef A, Fawaz AA. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults. Eur Arch Otorhinolaryngol. 2008 Mar;265(3):351-5. [DOI:10.1007/s00405-007-0451-5] [PMID]
4. Nitzan D W, Dolwick M F. Temporomandibular joint fibrous ankylosis following orthognathic surgery: report of eight cases. International Journal of Adult Orthodontics and Orthognathic Surgery. 1989;4(1):7-11.
5. Kim Y K. Complications associated with orthognathic surgery. J Korean Assoc Oral Maxillofac Surg. 2017;43(1):3-15. [DOI:10.5125/jkaoms.2017.43.1.3] [PMID] [PMCID]
6. Mobini A, Mehra P, Chigurupati R. Postoperative Pain and Opioid Analgesic Requirements After Orthognathic Surgery. J Oral Maxillofac Surg. 2018 Nov;76(11):2285-95. [DOI:10.1016/j.joms.2018.05.014] [PMID]
7. Talebi H, Kamali A, l Moshiri E, yazdi B, Hosseini M. Efficacy of intravenous acetaminophen injection on pain intensity and opioid consumption in patients undergoing radius shaft fracture surgery. JAP. 2014; 5(3):64-72.
8. James MF. Clinical use of magnesium infusions in anesthesia. Anesth Analg. 1992 Jan;74(1):129-36. [DOI:10.1213/00000539-199201000-00021] [PMID]
9. Shin HJ, Na HS, Do SH. Magnesium and Pain. Nutrients. 2020 Jul 23;12(8):2184. [DOI:10.3390/nu12082184] [PMID] [PMCID]
10. Miller RD. Miller's Anesthesia. 7 th ed. Philadelphia: Churchill livingstone/Elsevier;2010. 3312 p.
11. Memis D, Inal MT, Kavalci G, Sezer A, Sut N, et al. Intravenous paracetamol reduced the use of opioids, extubation time, and opioid-related adverse effects after major surgery in intensive care unit. J Crit Care. 2010 Sep; 25 (3):458-62. [DOI:10.1016/j.jcrc.2009.12.012] [PMID]
12. Kalani N, Sanie MS, Zabetian H, Radmehr M, Sahraei R, Kargar Jahromi H. Comparison of the Analgesic Effect of Paracetamol and Magnesium Sulfate during Surgeries. World J Plast Surg. 2016 Sep;5(3):280-6.
13. Davoudi M, Tahmasebi R, Zolhavareih S M. Evaluation of the Effect of Intravenous Magnesium Sulfate on Post-operative Pain after Cesarean Section under Spinal Anesthesia. Avicenna J Clin Med. 2013; 19(4):20-6.
14. Xie M, Li XK, Peng Y. Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: A systematic review and meta-analysis. J Evid Based Med. 2017;10:16-25. [DOI:10.1111/jebm.12230] [PMID]
15. Mostafa RH, Saleh AN, Ibrahim IM. The prophylactic effect of intravenous magnesium infusion on postoperative sore throat after thyroid surgery. A randomized clinical trial. Rev Chil Anest. 2020;49:528-37. [DOI:10.25237/revchilanestv49n04-09]
16. Hamed MA, Al-Saeed MA. The Efficacy of Intravenous Magnesium Sulfate versus Intravenous Paracetamol on Children Posttonsillectomy Pain and Analgesic Requirement: A Randomized Controlled Study. Anesth Essays Res. 2018 Jul-Sep;12(3):724-728. [DOI:10.4103/aer.AER_113_18] [PMID] [PMCID]
17. Damirchi AN, Kamali A, Azami M, Monfared ME. Comparison of the effect of Apotel and pregabalin on postoperative pain among patients undergoing lower limb orthopedic surgeries. J Family Med Prim Care. 2019 Jul;8(7): 2405-2408. [DOI:10.4103/jfmpc.jfmpc_396_19] [PMID] [PMCID]
18. Santhi Sree M, Usha Rani A. Efficacy of intraoperative I.v Magnesium sulfate versus Iv Paracetamol on post-operative analgesic requirement in major surgeries under general anesthesia. IOSR J Dent Med Sci (IOSR-JDMS). 2018; 17:1-11.
19. Cristalli MP, La Monaca G, De Angelis C, Pranno N, Annibali S. Efficacy of Preoperative Administration of Paracetamol-Codeine on Pain following Impacted Mandibular Third Molar Surgery: A Randomized, Split-Mouth, Placebo-Controlled, Double-Blind Clinical Trial. Pain Res Manag. 2017;2017:9246352. [DOI:10.1155/2017/9246352] [PMID] [PMCID]
20. Shin HJ, Kim EY, Na HS, Kim TK, Kim MH, Do SH. Magnesium sulphate attenuates acute postoperative pain and increased pain intensity after surgical injury in staged bilateral total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial. Br J Anaesth. 2016 Oct;117(4):497-503. [DOI:10.1093/bja/aew227] [PMID]
21. Hwang JY, Na HS, Jeon YT, Ro YJ, Kim CS, Do SH. I.V. infusion of magnesium sulfate during spinal anesthesia improves postoperative analgesia. Br J Anaesth. 2010 Jan; 104(1):89-93. [DOI:10.1093/bja/aep334] [PMID]
22. Koinig H, Wallner T, Marhofer P, Andel H, Hörauf K, Mayer N. Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesth Analg. 1998 Jul;87(1):206-10. [DOI:10.1213/00000539-199807000-00042]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2022 CC BY-NC 4.0 | Journal of Research in Dental and Maxillofacial Sciences

Designed & Developed by : Yektaweb