Evaluation of preemptive and preventive use of coadministration of ibuprofen L-arginine and dexamethasone on clinical and laboratory parameters, quality of life, pain catastrophizing, and sleep quality in lower third molar surgeries: a randomized, split-mouth, controlled trial

Abstract

Objective The aim of this study is to compared the effect of different preemptive and preventive analgesia strategies involving the oral coadministration of ibuprofen-arginine (770mg)–Ib-Ar and dexamethasone (8mg)-DX, and their respective placebos (P-Ib-Ar and P-DX), four evaluation groups on inflammatory and laboratory parameters, and impact on quality of life, pain catastrophizing perception and sleep quality related after lower third molar (L3M) surgery. Material and methods A randomized split-mouth, triple-blind, controlled clinical trial was conducted with 48 volunteers. They were allocated depending on the use of Ib-Ar or DX, 1 hour before surgery or immediately postoperatively, discriminating the groups: G1 (Ib-Ar + DX), G2 (Ib-Ar + P-DX), G3 (P-Ib-Ar + DX), and G4 (P-Ib-Ar + P-DX). Results Pain peaks occurred after 2h (P-Ib-Ar group) (p = 0.003), while the other groups showed peak pain after 4h (p < 0.05). The initial mouth opening amplitude did not differ between groups (p < 0.001). Regarding the edema: groups treated with P-Ib-Ar and the P-DX group; measurements significantly reduced without returning to baseline (p < 0.001). Regarding laboratory parameters: MPO and MDA levels, the Ib-Ar + DX group (p < 0.001) was the only one showing a significant reduction. Conclusion The use of preemptive and preventive analgesia strategies involving oral coadministration of Ib-Ar and DX (G1) showed that the combined use delayed peak pain, with no difference in edema and trismus. The benefit of coadministration of both strategies was superior to the isolated use of drugs. Clinical relevance Translational study with impact on clinical-surgical protocols involving L3M surgery related to pharmacological methods.