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Can Acetaminophen Pretreatment Decrease the Pain Associated With Closed Nasal Bone Reduction? A Triple-Blind

Saeed Sohrabpour1, Mozhgan Safaeyan2, Kayvan Aghazadeh1

  • 1Assistant Professor of Otolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|December 28, 2020
PubMed
Summary
This summary is machine-generated.

Preemptive acetaminophen did not reduce pain during nasal bone reduction under local anesthesia. This study found no significant pain relief benefit compared to placebo, suggesting its use is not justified for this procedure.

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Area of Science:

  • Maxillofacial Surgery
  • Pain Management
  • Clinical Trials

Background:

  • Nasal bone fractures are common maxillofacial injuries.
  • Nasal bone reduction is typically performed under local anesthesia, which can be painful.
  • Effective pain management strategies are crucial for patient comfort during this procedure.

Purpose of the Study:

  • To evaluate the efficacy of pre-emptive acetaminophen analgesia in reducing pain associated with nasal bone reduction under local anesthesia.
  • To compare pain scores between patients receiving acetaminophen and those receiving a placebo before nasal bone reduction.
  • To determine if acetaminophen pretreatment offers a significant analgesic benefit in this clinical setting.

Main Methods:

  • A triple-blind, randomized clinical trial involving 100 patients with nasal fractures eligible for closed reduction.
  • Participants were randomized into two groups: one receiving a 500-mg acetaminophen tablet 45 minutes prior to reduction, and the other receiving a placebo.
  • Pain scores were assessed using the visual analog scale (VAS) during local anesthesia, during reduction, and 24 hours post-reduction. Data were analyzed using chi-squared and Mann-Whitney tests.

Main Results:

  • No statistically significant difference in pain scores was observed between the acetaminophen and placebo groups.
  • Surgeon satisfaction analysis also showed no significant difference between the two groups.
  • Correlation analysis indicated that the number of reduction attempts was the only factor significantly associated with pain severity during the procedure.

Conclusions:

  • Pre-emptive administration of acetaminophen does not provide additional analgesia compared to placebo for nasal bone reduction under local anesthesia.
  • The use of acetaminophen prior to nasal bone reduction is not clinically justified based on these findings.
  • Further research may explore alternative or multimodal analgesia strategies for this painful procedure.