Analgesic Potential Comparison Between Piperine-Combined Curcumin Patch and Non-Piperine Curcumin Patch: A Pragmatic Trial on Post-Cleft Lip/Palate Surgery Pediatric Patients

Abstract

Tantry Maulina,1,2 Yohanes Yoppy Purnomo,3 Nadya Khamila,4 Devy Garna,5 Endang Sjamsudin,1 Arief Cahyanto6 1Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia; 2Dentistry Department, Radboud University, Nijmegen, the Netherlands; 3Faculty of Dentistry, Maranatha Christian University, Bandung, Indonesia; 4Oral Surgery and Maxillofacial Specialist Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia; 5Periodontology Department, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia; 6Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, MalaysiaCorrespondence: Tantry Maulina, Dentistry Department, Radboud University, Nijmegen, Gelderland, the Netherlands, Email [email protected]; [email protected]: Despite its well-acknowledged analgesic potential, curcumin’s low bioavailability has been recognized. Piperine, a substance naturally contained in pepper, has been known for its effect on increasing curcumin bioavailability. To investigate the analgesic potential of curcumin and piperine addition to curcumin patch used as adjuvant therapy in the management of acute postoperative orofacial pain.Patients and Methods: This pragmatic trial recruited 75 patients that underwent oromaxillofacial surgery at Unpad Dental Hospital, Bandung, Indonesia. Research participants were randomly assigned to three different groups: the first group that did not receive any intervention other than the post-operative standard treatment (POST), the second group that received POST and non-piperine curcumin patch, and the third group that received POST and piperine-combined curcumin patch. Participants’ pain intensity was evaluated by using the face, leg, activity, cry, and consolability (FLACC) pain scale and salivary prostaglandin-E2 (PGE2) level for two-time points, which were eight hours apart. All data were gathered and analyzed to compare the within and between-group differences.Results: Within groups comparison of the FLACC scores for two evaluation points showed significant differences for all groups (p < 0.01). For salivary PGE2 analysis, a comparison of the non-piperine group to the piperine group also showed significant results. Yet, when all three groups were compared, regardless of the differences, the results were not statistically significant.Conclusion: Despite of the proven efficacy of curcumin patch, the addition of piperine to the curcumin patch in the current study did not provide any significant effects. Further investigation is of importance.Keywords: curcumin, piperine, acute postoperative pain, oromaxillofacial surgery, cleft lip, cleft palate

Keywords

• curcumin
• piperine
• acute postoperative pain
• oromaxillofacial surgery
• cleft lip
• cleft palate.