Evaluation of the effects of pregabalin and dexamethasone coadministration on preemptive multimodal analgesia and anxiety in third molar surgeries: a triple-blind randomized clinical trial

• Published in: Clinical oral investigations Vol. 28; no. 6; p. 304
• Main Authors: Diniz, Jiordanne Araújo, Dourado, Ana Cláudia Amorim Gomes, Barbirato, Davi da Silva, de Oliveira, Maysa Swellen Valentim, de Lira, Vitória Layla Bezerra de Oliveira, de Melo Filho, Sérgio Murilo Cordeiro, da Silveira, Karoline Gomes, Laureano Filho, José Rodrigues
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 08-05-2024; Springer Nature B.V
• Subjects: Adult; Analgesia; Analgesics; Analgesics - therapeutic use; Anesthesia; Anxiety; Blood pressure; Clinical outcomes; Clinical trials; Dental Anxiety - prevention & control; Dentistry; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; Drug Therapy, Combination; Female; Heart rate; Humans; Male; Medicine; Molar, Third - surgery; Oxygen saturation; Pain management; Pain Management - methods; Pain Measurement; Pain perception; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; Patients; Postoperative period; Pregabalin - therapeutic use; Surgery; Surveys and Questionnaires; Tooth Extraction; Treatment Outcome; Conscious sedation; Anxiety; Pain; Dexamethasone; Pregabalin; Third molar
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-024-05700-8

Objective
To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery.
Materials and methods
A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO
2
)], and sedation assessed by the Ramsay scale.
Results
A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (
p
 < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (
p
 < 0.05) and a significant reduction in HR at two different time intervals (
p
 = 0.003 and
p
 = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO
2
between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (
p
 < 0.05). There were no significant postoperative adverse effects.
Conclusions
Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect.
Clinical relevance
The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries.
Trial registration
Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.