Efficacy of preemptive oral doses of acetaminophen and celecoxib for post-operative pain management after open-flap debridement: A randomised controlled study

Abstract

Background: Open-flap debridement therapy often leads to frequent pain postoperatively. It has been reported that open-flap debridement causes pain in 79% of patients. The preemptive approach focuses on preventing post-operative analgesic flare and blocking the occurrence of hyperalgesic states. This study aimed to compare the preemptive analgesia of oral celecoxib with oral acetaminophen after surgical open-flap debridement. Materials and Methods: A randomised, double-blinded, placebo-controlled research was conducted to study the patients presenting with an open-flap debridement under local anaesthesia. A total of forty patients were randomised to receive open-flap debridement, and either celecoxib or acetaminophen was prescribed. Visual analogue scale (VAS) pain score was noted every 2, 4, 6, 8, 10 12 and 20 h post-surgery. Consumption of analgesics was also recorded postoperatively. Results: The average age and weight of the patients in the celecoxib group were 35.85 ± 8.32 and 54.75 ± 8.90 kg, respectively. The average age and weight of the patients in the acetaminophen group were 36.8 ± 8.71 and 53.15 ± 9.90 kg, respectively. The mean VAS pain score at 4 h was 2.6 ± 1.14 and 4.9 ± 1.20 for celecoxib and acetaminophen groups, respectively. The mean post-operative analgesic drug consumption in the celecoxib group was 0.60 ± 0.87 and 1.30 ± 0.80 in the acetaminophen group. Conclusion: Celecoxib shows a significant preemptive analgesic effect, thereby reducing the use of post-surgical analgesics after open-flap debridement. Hence, pre-surgical single dose of celecoxib can be used to minimise the post-operative analgesic use.

Keywords

• acetaminophen
• celecoxib
• pain management
• periodontal surgery