ANALGESIC EFFECT OF INTRAVENOUS ASCORBIC ACID VERSUS ACELCOFENAC POST-TRANSALVEOLAR EXTRACTION A CASE CONTROL STUDY
Main Article Content
Keywords
third molar extraction, IV vitamin C, aceclofenac, post-surgical pain, trismus, facial swelling
Abstract
One of the most important aspects of postsurgical care is finding an efficient way for the management of pain. Third molar extractions/surgical impaction is one of the most frequent surgical procedures in dental hospitals, and it is most often associated with postoperative complications like severe pain, oedema and reduced mouth opening. This study was aimed to evaluate the efficacy of 2 g intravenous (IV) vitamin C compared to 100 mg aceclofenac on postsurgical pain, swelling and trismus after the surgical removal of third molars. A total of 101 patients were recruited for the study, and they were divided into two treatment groups; group A (n = 51) received 2 g IV vitamin C and group B (n = 50) received 100 mg aceclofenac. Pain intensity, facial swelling and mouth opening were assessed till day 3 post-surgically. Statistical analysis of pain intensity revealed that IV vitamin C performed slightly better but not significantly different (p>0.05) from aceclofenac group at the end of day 3. No significant difference for facial swelling and mouth opening between the two treatment protocols was seen (p>0.05). Our results concluded that both treatment groups were overall similar in analgesic efficacy, postoperative oedema and reduction in mouth opening. It was also determined that the method devised administering 2 g IV vitamin C intravenously was well suited to the treatment of postoperative pain, swelling and trismus following the surgical extraction of impacted third molars.
References
1. Friedman JW. The prophylactic extraction of third molars: A public health hazard. Am J Public Health. 2007;97(9):1554–9.
2. Haug RH, Perrott DH, Gonzalez ML, Talwar RM. The American Association of Oral and Maxillofacial Surgeons Age-Related Third Molar Study. J Oral Maxillofac Surg. 2005 Aug;63(8):1106–14.
3. Friedman JW. Containing the cost of third-molar extractions: A dilemma for health insurance. Public Health Rep. 1983;98(4):376–84.
4. Leonard MS. Removing third molars: A review for the general practitioner. J Am Dent Assoc. 1992;123(2):77–8, 81–2, 5–6.
5. Colorado-Bonnin M, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Quality of life following lower third molar removal. Int J Oral Maxillofac Surg. 2006;35(4):343–7.
6. Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvao EL. Third molar removal and its impact on quality of life: Systematic review and meta-analysis. Qual Life Res. 2018;27(10):2477–89.
7. van Wijk A, Kieffer JM, Lindeboom JH. Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of Oral Health Impact Profile-14. J Oral Maxillofac Surg. 2009;67(5):1026–31.
8. Zuniga JR, Phillips CL, Shugars D, et al. Analgesic safety and efficacy of diclofenac sodium softgels on postoperative third molar extraction pain. J Oral Maxillofac Surg. 2004;62(7):806–15.
9. Roelofse JA, Van der Bijl P, Joubert JJ. Analgesic and anti-inflammatory efficacy of tenoxicam and diclofenac sodium after third molar surgery. Anesth Prog. 1996;43(4):103–7.
10. Gobetti JD. Controlling dental pain. J Am Dent Assoc. 1992;123:47–52.
11. Derry C, Derry S, Moore RA, McQuay HJ. Single dose oral ibuprofen for acute postoperative pain in adults. Cochrane Database Syst Rev. 2009;(3):CD001548.
12. Daniels SE, Goulder MA, Aspley S, Reader S. A randomised, five-parallel-group, placebo-controlled trial comparing the efficacy and tolerability of analgesic combinations including a novel single-tablet combination of ibuprofen/paracetamol for postoperative dental pain. Pain. 2011;152(3):632–42.
13. Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2013;(6):CD010210.
14. Chunduri NS, Kollu T, Goteki VR, Mallela KK, Madasu K. Efficacy of aceclofenac and diclofenac sodium for relief of postoperative pain after third molar surgery: A randomised open label comparative study. J Pharmacol Pharmacother 2013;4(2):144–5.
15. Jyothsna K, Deshpande N, Vijayalakshmi G. Efficacy and safety of diclofenac sodium and aceclofenac in controlling post extraction dental paIn: A randomised open label comparative study. J Pharmacol Toxicol. 2011;6(5):541–7.
16. Chaitanya NC, Muthukrishnan A, Krishnaprasad CMS, Sanjuprasanna G, Pillay P, Mounika B. An insight and update on the analgesic properties of vitamin C. J Pharm Bioallied Sci. 2018;10(3):119–25.
17. Catani MV, Savini I, Rossi A, Melino G, Avigliano L. Biological role of vitamin C in keratinocytes. Nutr Rev. 2005;63(3):81–90.
18. Popovich D, McAlhany A, Adewumi AO, Barnes MM. Scurvy: Forgotten but definitely not gone. J Pediatr Health Care. 2009;23(6):405–15.
19. Schencking M, Vollbracht C, Weiss G, et al. Intravenous vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study. Med Sci Monit. 2012;18(4):Cr215–24.
20. Chen JY, Chu CC, So EC, Hsing CH, Hu ML. Treatment of postherpetic neuralgia with intravenous administration of vitamin C. Anesth Analg. 2006;103(6):1616–17.
21. Jensen NH. [Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. Ugeskr Laeger. 2003;165(25):2563–6.
22. Carr AC, Vissers MCM, Cook JS. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life. Front Oncol. 2014;4(283):1–7.
23. Cameron E, Campbell A. The orthomolecular treatment of cancer. II. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. Chem Biol Interact. 1974;9(4):285–315.
24. Jeon Y, Park JS, Moon S, Yeo J. Effect of intravenous high dose vitamin C on postoperative pain and morphine use after laparoscopic colectomy: A randomized controlled trial. Pain Res Manag. 2016;2016:6.
25. Amin MM, Laskin DM. Prophylactic use of indomethacin for prevention of postsurgical complications after removal of impacted third molars. Oral Surg Oral Med Oral Pathol. 1983;55(5):448–51.
26. Deliverska EG, Petkova M. Complications after extraction of impacted third molars- literature review. J IMAB. 2016;22(3):1202–11.
27. Contar CM, de Oliveira P, Kanegusuku K, Berticelli RD, Azevedo-Alanis LR, Machado MA. Complications in third molar removal: A retrospective study of 588 patients. Med Oral Patol Oral Cir Bucal. 2010;15(1):e74–8.
28. Carr AC, McCall C. The role of vitamin C in the treatment of pain: New insights. J Transl Med. 2017;15(1):77.
29. Benediktsdottir I, Wenzel A, Petersen J, et al. Mandibular- third molar removal: Risk indicators for extended operation time, postoperative pain and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:438–46.
30. Yasin MF, Tawfiq NO. Aceclofenac efficacy on pain, trismus and swelling after surgical removal of impacted wisdom teeth. Int J Enhan Res Med Dent Care. 2017;4(3):25–31.
31. Jatin K, Lata J, Singh TPA. Comparative study on the efficacy of rofecoxib and ibuprofen in controlling post-operative sequelae following third molar surgeries. J Maxillofac O Surg. 2007;6(1):17–21.
32. Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL, Arotiba GT, Ogunlewe MO. Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery. Head Face Med. 2005;1:11.
33. Stephenson CM, Levin RD, Spector T, Lis CG. Phase i clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer. Cancer Chemother Pharmacol. 2013;72:139–46.
34. Mikirova N, Casciari J, Riordan N, Hunninghake R. Clinical experience with intravenous administration of ascorbic acid: Achievable levels in blood for different states of inflammation and disease in cancer patients. J Transl Med. 2013;11:191.
2. Haug RH, Perrott DH, Gonzalez ML, Talwar RM. The American Association of Oral and Maxillofacial Surgeons Age-Related Third Molar Study. J Oral Maxillofac Surg. 2005 Aug;63(8):1106–14.
3. Friedman JW. Containing the cost of third-molar extractions: A dilemma for health insurance. Public Health Rep. 1983;98(4):376–84.
4. Leonard MS. Removing third molars: A review for the general practitioner. J Am Dent Assoc. 1992;123(2):77–8, 81–2, 5–6.
5. Colorado-Bonnin M, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Quality of life following lower third molar removal. Int J Oral Maxillofac Surg. 2006;35(4):343–7.
6. Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvao EL. Third molar removal and its impact on quality of life: Systematic review and meta-analysis. Qual Life Res. 2018;27(10):2477–89.
7. van Wijk A, Kieffer JM, Lindeboom JH. Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of Oral Health Impact Profile-14. J Oral Maxillofac Surg. 2009;67(5):1026–31.
8. Zuniga JR, Phillips CL, Shugars D, et al. Analgesic safety and efficacy of diclofenac sodium softgels on postoperative third molar extraction pain. J Oral Maxillofac Surg. 2004;62(7):806–15.
9. Roelofse JA, Van der Bijl P, Joubert JJ. Analgesic and anti-inflammatory efficacy of tenoxicam and diclofenac sodium after third molar surgery. Anesth Prog. 1996;43(4):103–7.
10. Gobetti JD. Controlling dental pain. J Am Dent Assoc. 1992;123:47–52.
11. Derry C, Derry S, Moore RA, McQuay HJ. Single dose oral ibuprofen for acute postoperative pain in adults. Cochrane Database Syst Rev. 2009;(3):CD001548.
12. Daniels SE, Goulder MA, Aspley S, Reader S. A randomised, five-parallel-group, placebo-controlled trial comparing the efficacy and tolerability of analgesic combinations including a novel single-tablet combination of ibuprofen/paracetamol for postoperative dental pain. Pain. 2011;152(3):632–42.
13. Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2013;(6):CD010210.
14. Chunduri NS, Kollu T, Goteki VR, Mallela KK, Madasu K. Efficacy of aceclofenac and diclofenac sodium for relief of postoperative pain after third molar surgery: A randomised open label comparative study. J Pharmacol Pharmacother 2013;4(2):144–5.
15. Jyothsna K, Deshpande N, Vijayalakshmi G. Efficacy and safety of diclofenac sodium and aceclofenac in controlling post extraction dental paIn: A randomised open label comparative study. J Pharmacol Toxicol. 2011;6(5):541–7.
16. Chaitanya NC, Muthukrishnan A, Krishnaprasad CMS, Sanjuprasanna G, Pillay P, Mounika B. An insight and update on the analgesic properties of vitamin C. J Pharm Bioallied Sci. 2018;10(3):119–25.
17. Catani MV, Savini I, Rossi A, Melino G, Avigliano L. Biological role of vitamin C in keratinocytes. Nutr Rev. 2005;63(3):81–90.
18. Popovich D, McAlhany A, Adewumi AO, Barnes MM. Scurvy: Forgotten but definitely not gone. J Pediatr Health Care. 2009;23(6):405–15.
19. Schencking M, Vollbracht C, Weiss G, et al. Intravenous vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study. Med Sci Monit. 2012;18(4):Cr215–24.
20. Chen JY, Chu CC, So EC, Hsing CH, Hu ML. Treatment of postherpetic neuralgia with intravenous administration of vitamin C. Anesth Analg. 2006;103(6):1616–17.
21. Jensen NH. [Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. Ugeskr Laeger. 2003;165(25):2563–6.
22. Carr AC, Vissers MCM, Cook JS. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life. Front Oncol. 2014;4(283):1–7.
23. Cameron E, Campbell A. The orthomolecular treatment of cancer. II. Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. Chem Biol Interact. 1974;9(4):285–315.
24. Jeon Y, Park JS, Moon S, Yeo J. Effect of intravenous high dose vitamin C on postoperative pain and morphine use after laparoscopic colectomy: A randomized controlled trial. Pain Res Manag. 2016;2016:6.
25. Amin MM, Laskin DM. Prophylactic use of indomethacin for prevention of postsurgical complications after removal of impacted third molars. Oral Surg Oral Med Oral Pathol. 1983;55(5):448–51.
26. Deliverska EG, Petkova M. Complications after extraction of impacted third molars- literature review. J IMAB. 2016;22(3):1202–11.
27. Contar CM, de Oliveira P, Kanegusuku K, Berticelli RD, Azevedo-Alanis LR, Machado MA. Complications in third molar removal: A retrospective study of 588 patients. Med Oral Patol Oral Cir Bucal. 2010;15(1):e74–8.
28. Carr AC, McCall C. The role of vitamin C in the treatment of pain: New insights. J Transl Med. 2017;15(1):77.
29. Benediktsdottir I, Wenzel A, Petersen J, et al. Mandibular- third molar removal: Risk indicators for extended operation time, postoperative pain and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:438–46.
30. Yasin MF, Tawfiq NO. Aceclofenac efficacy on pain, trismus and swelling after surgical removal of impacted wisdom teeth. Int J Enhan Res Med Dent Care. 2017;4(3):25–31.
31. Jatin K, Lata J, Singh TPA. Comparative study on the efficacy of rofecoxib and ibuprofen in controlling post-operative sequelae following third molar surgeries. J Maxillofac O Surg. 2007;6(1):17–21.
32. Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL, Arotiba GT, Ogunlewe MO. Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery. Head Face Med. 2005;1:11.
33. Stephenson CM, Levin RD, Spector T, Lis CG. Phase i clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer. Cancer Chemother Pharmacol. 2013;72:139–46.
34. Mikirova N, Casciari J, Riordan N, Hunninghake R. Clinical experience with intravenous administration of ascorbic acid: Achievable levels in blood for different states of inflammation and disease in cancer patients. J Transl Med. 2013;11:191.
Article Sidebar
Published
Aug 14, 2019
Article Details
How to Cite
Chaitanya, N. C., Badam, R., Reddy, G. S. P., Alwala, A., Srinivas, P., Saawarn, N., Chintada, S., Akhila, M., Bontala, P., Inamdar, P., & Mannava, H. (2019). ANALGESIC EFFECT OF INTRAVENOUS ASCORBIC ACID VERSUS ACELCOFENAC POST-TRANSALVEOLAR EXTRACTION: A CASE CONTROL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 26(2), e43-e52. https://doi.org/10.15586/jptcp.v26i2.626
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biography
Nallan CSK Chaitanya, Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences, Hyderabad, India.
Professor in Oral Medicine and Radiology
How to Cite
Chaitanya, N. C., Badam, R., Reddy, G. S. P., Alwala, A., Srinivas, P., Saawarn, N., Chintada, S., Akhila, M., Bontala, P., Inamdar, P., & Mannava, H. (2019). ANALGESIC EFFECT OF INTRAVENOUS ASCORBIC ACID VERSUS ACELCOFENAC POST-TRANSALVEOLAR EXTRACTION: A CASE CONTROL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 26(2), e43-e52. https://doi.org/10.15586/jptcp.v26i2.626