Aims: To evaluate the efficacy of intravenous preemptive analgesia on postoperative pain in children undergoing dental rehabilitation under general anesthesia.
Keywords: children, dental treatment, general anesthesia, opioid, postoperative pain
Methods: In this prospective randomized clinical trial, 70 children aged 3 to 7 years were scheduled for dental treatment and randomized into two groups: the control group or the preemptive group. Patients received 15 mg/kg of intravenous paracetamol either before the start of treatment (preemptive group, n = 35) or at the end of treatment (control group, n = 35). Postoperative pain scores were recorded at 1, 2, 4, 6, 8, 12, and 24 hours using the Wong-Baker FACES Pain Rating Scale (WBFS). Additionally, the need for rescue analgesic and the total opioid consumption of the patients were recorded during the first 24 hours postoperative.
Results: The pain scores in the preemptive group were significantly lower than those in the control group at the postanesthesia care unit and at 2, 4, and 8 hours postoperative (P < .05). However, there were no statistically significant differences in pain scores between groups at 12 and 24 hours postoperative. Need for rescue analgesics and total intravenous fentanyl consumption were significantly higher in the control group than in the preemptive group (P < .05). The percentage of children who received medication for pain relief at home was higher in the control group than in the preemptive group, but the difference was not statistically significant (P > .05).
Conclusion: Preemptive use of intravenous paracetamol reduces postoperative pain scores and postoperative opioid consumption. However, there is a need to evaluate pain levels in children who receive comprehensive dental treatment under general anesthesia after hospital discharge for effective postoperative pain control.