Efficiency and Safety of Cyclooxygenase-2 Inhibitors (Cox-2) as a Post-Surgical Pain Killer Related to Maxillofacial Surgery
Abstract
Introduction: Powerful postoperative pain control requires pain-relieving with fast acting and long duration of activity. Non-steroidal anti-inflammatory drugs (NSAIDs) have an opioid impact when utilized postoperatively, however, they tend to demonstrate a slower beginning of the activity. A few studies showed that COX-2 inhibitors are t as powerful as NSAIDs. The aim of this review is to evaluate the efficacy and safety of Cyclooxygenase-2 inhibitors (Cox-2) for the relief of acute postoperative pain focusing on the dental settings.
Methods: The electronic search of the literature in MEDLINE and EMBASE identified 132 articles that underwent full-text review and 10 met our inclusion criteria. The electronic search of the literature in MEDLINE and EMBASE identified 132 articles that underwent full-text review and 10 met our inclusion criteria. These articles examine the efficacy and safety of Cyclooxygenase-2 inhibitors (Cox-2) for the relief of acute postoperative pain in surgeries such as extraction of impacted third mandibular molar, open-flap debridement periodontal surgeries, mandibular fractures, and cranial fractures.
Results: The effectiveness of Cox-2 inhibitors, was found to be significantly different in Celecoxib in only one study, and with no significant difference in 3 studies, Etoricoxib with Celecoxib in one study also significantly reduced the postoperative pain, while in Parecoxib all the studies significantly reduced the pain. Regarding the safety of Cox-2 inhibitors, the side effects were more in Celecoxib than in placebo in some studies, and more in the placebo than in Parecoxib in few studies. No significant differences were found in some included studies.
Conclusion: The specific COX-2 inhibitor Celecoxib might be helpful for the treatment of severe pain. Its utilization might be especially attractive for elderly people and patients with a background marked by gastrointestinal issues.
