Estudo comparativo de drogas antiinflamatórias não - esteroidais (Nimesulide, Cetaprofeno e Diclofenaco potássico) em pós - operatórios de terceiros molares inferiores mesio - angulares

Abstract

Swelling, pain and loss of function are postoperative manifestations of inflammation due to tissue injury during surgical procedures. Pharmacologic strategies for minimizing the clinical manifestations are conducted to block the formation or inhibiting the effects of the mediators of acute inflammation. The management of pain and inflammation is a critical component of postoperative patient care. Clinicians prescribe nonsteroidal anti-inflammatory drugs (NSAIDS) to their patients on their routine basis for various types of pain. Nonsteroidal anti-inflammatory drugs as the diclofenac and the ketoprofen are routinely prescribed in oral clinics. Regarding to these medicine, is known that they are well accepted for their low cost, high effectiveness, low toxicity and similar action mechanism; their inconvenient is the formation of the gastrointestinal injuries due to inhibition of the synthesis of prostaglandin (for action in the COX-1). The nimesulide is a nonsteroidal antiinflammatory with selective action in the COX-2, wich doesn´t present the same side effects. It´s aware that potassic diclofenac, ketoprofen and nimesulide are anti-inflammatory and analgesic drugs usually used in postoperative surgical oral treatment. The purpose of this study was check the effectiveness of anti-inflammatory drugs in patients who underwent by surgical removal of lower third molars procedure.Pain, quality of sleep, difficulty on chewing, side effects, trismus and swelling were the parameters evaluate in our study.It was possible to verify that the nimesulide proved effectiveness to reducing with importance the postoperative pain (p< 0,05) when it was compared to patient who were treated with ketoprofen and diclofenac. When analysed the quality of sleep of the patients who underwent by surgical removal of lower third molars procedure, it was possible to verify that patients treated with nimesulide had a slightest damage in theirs quality of sleep (p< 0,05) after 24 and 72 hours of the oral surgery. Also was possible to verify that all patients underwent by surgical procedure showed difficulty on chewing after the treatment with this anti-inflammatory drugs, without they presented statistics difference between the groups. All medicines showed side effects, however, there wasn´t statistics difference in these various treatments. There´s no statistics difference in relation to patient s trismus either. The nimesulide couldn´t minimize the patient s swelling caused by surgery trauma and showed less effective that ketoprofen (p< 0,05). Therefore, the anti-inflammatory nimesulide showed an improvement of the postoperative symptoms of patients who underwent by surgical removal of lower third molars procedure.