An interesting article titled “Does low dose of etoricoxib play pre-emptive analgesic efect in third molar surgery? A randomized clinical trial” written by Long Xie and et al. appears in BMC Oral Health (vol. 21, no. 462, 2021). The article discusses the results of a randomized clinical trial that explored if a preemptive low dose of the nonsteroidal anti-inflammatory drug (NSAID) etoricoxib may reduce the need for analgesics after wisdom teeth extraction.
The study the authors conducted was designed as randomized, parallel, double-blinded and placebo-controlled and occurred between August 2019 and July 2020. A total of 56 patients were included in the study that met the inclusion criteria and scheduled to have impacted horizontal mandibular wisdom teeth extracted. The authors found that the mean VAS pain score in the etoricoxib group was significantly lower than that in the placebo group in the first 12 hours after the surgery follow-up. The authors also found that, a total of 28 of these patients were given 60 mg of etoricoxib prior to their surgery and the other 28 patients were given placebo. Patients who take etoricoxib prior to surgery required less analgesics after wisdom teeth extraction. Specifically 8 of the 28 patients who took etoricoxib prior to surgery required anagesic medication within 24 hours of evaluation, while 21 of the 28 patients who took placebo prior to surgery required anagesic medication within 24 hours of evaluation. Further the total analgesic consumption for the postoperative 24 hour period was 0.4 +/- 0.9 tablets for the etoricoxib group and 1.1 +/- 0.9 tablets for the placebo group. The authors said that the statistical difference between the two groups could be attributed to etoricoxib. The authors state:
“Etoricoxib (60 mg) significantly reduced the pain scores during the first 12 postoperative hours, resulting in longer overall survival time (the interval to the frst intake of ibuprofen) and reduced need of rescued analgesic consumption within 24 h after the surgery.”
The authors point out a few limitations of the study that include there was not another group to serve a positive control group that was given NSAID analgesics and that the follow-up time was only 24 hours and the pain assessment was not conducted exactly at 24 hours after surgery.
Etoricoxib is a selective inhibitor of the cyclooxygenase-2 (COX2) enzyme and is effective at reliving pain during dental procedures with minimal side effects. The authors used a low dose (60 mg) of etoricoxib in their study instead of the more common dosage of 120 mg where more research has been conducted. In the discussion the authors compare their results with those of other studies using etoricoxib at 60 mg or 120 mg for other conditions like osteoarthritis and controlling pain during fixed orthodontic appliance therapy. They also discussed another study that used 120 mg of etoricoxib after the removal of two or more wisdom teeth and how in their study less etoricoxib was needed because it was taken pre emptively.
The authors seem to think the dosage they used in their study worked well as they state
“In this study, a pre-emptive of low dose of etoricoxib was enough to induce good analgesia with no side effects.”
They caution that a larger dose could result in more side effects.
Etoricoxib is the good way before surgery to avoid severe tooth pain. Keep sharing.
Taking etoricoxib before the teeth surgery can be really helpful but the great thing is that you have completely explained how many doses we need to take according to situation. Really Nice Article.
Nice solution for severe pain. Is there any other way except etoricoxib?
Thanks for sharing the valuable post. Keep it up.
In my situation, the pain-relieving advice you gave me was quite helpful, so I appreciate you sharing this informative post.