72755
document
Preoperative Local Administration of Morphine as an Add-on Therapy in Patients Undergoing Surgical Removal of an Odontogenic Maxillary Cyst . A Randomized , Double-Blind Pilot Study . AIMS To evaluate whether a combination of locally administered morphine ( 1 mg ) and lidocaine as part of a multimodal analgesic approach is safe , and whether it improves pain control during the first 24 hours after odontogenic maxillary cyst removal under general anesthesia compared to local lidocaine alone . METHODS In a double-blind , sham-controlled , single-center trial , patients scheduled for surgical removal of an odontogenic maxillary cyst under general anesthesia were randomly assigned to receive a local injection of lidocaine solution with either 1 mg of morphine ( MLA group ) or with no morphine ( LA group ) . Pain management included intravenous acetaminophen ( 1 g every 6 hours ) in all patients . Upon request , the patients could additionally receive ketoprofen ( first-line additional analgesia ) or tramadol ( second-line additional analgesia ) . Pain intensity was assessed using a numeric rating scale . Primary outcome measures were ( 1 ) no need for any additional analgesic therapy and ( 2 ) time to the first rescue analgesic therapy during the first 24 hours after the surgery . RESULTS Of 48 eligible patients , 24 were allocated to the MLA group and 24 to the LA group . The necessity of additional ketoprofen therapy did not differ significantly between the groups ( 25.0 % vs 50.0 % , P=.074 ) . According to the Kaplan-Meier analysis , the probability of remaining without additional analgesic intervention was significantly higher in the MLA group ( log-rank test , P=.040 ) , but there were no significant ( P > .05 ) differences in overall and maximum pain severity between the two groups . No adverse effects of morphine were recorded . CONCLUSION Within the limitations of this study , local administration of 1 mg of morphine prior to the surgical removal of an odontogenic maxillary cyst was safe , but it did not prove to be very effective as an add-on therapy for postoperative pain control .
72756
Intervention_Pharmacological
Morphine
72757
Intervention_Pharmacological
morphine
72758
Intervention_Pharmacological
lidocaine
72759
Intervention_Pharmacological
lidocaine solution with either 1 mg of morphine ( MLA
72760
Intervention_Control
or with no morphine ( LA
72761
Intervention_Pharmacological
acetaminophen
72762
Intervention_Pharmacological
ketoprofen
72763
Intervention_Pharmacological
or tramadol
72764
Intervention_Pharmacological
ketoprofen
72765
Intervention_Pharmacological
morphine
72766
Outcome_Physical
( 1 ) no need for any additional analgesic therapy and ( 2 ) time to the first rescue analgesic therapy during the first 24 hours after the surgery .
72767
Outcome_Physical
additional ketoprofen therapy
72768
Outcome_Physical
additional analgesic intervention
72769
Outcome_Pain
pain severity
72770
Outcome_Adverse-effects
adverse effects
72771
Participant_Condition
Patients Undergoing Surgical Removal of an Odontogenic Maxillary Cyst
72772
Participant_Condition
the first 24 hours after odontogenic maxillary cyst removal under general anesthesia
72773
Participant_Condition
patients scheduled for surgical removal of an odontogenic maxillary cyst under general anesthesia
72774
Participant_Sample-size
48 eligible patients