第三磨牙拔除术后疼痛管理研究进展

The Progress in Research of Pain Management after the Third Molar Extraction

第三磨牙拔除术是口腔科常规手术,其术后疼痛是引起牙科恐惧的重要原因。目的:探究术后疼痛原因以及目前的术后疼痛管理是否完善。方法:本研究在KNS、Pubmed、万方数据库中进行了涵盖2014年1月至2020年1月的相关电子文献搜索,关键词为“第三磨牙拔除”、“术后疼痛”、“疼痛管理”、“疼痛干预”,以至少有一项关于牙拔除术后疼痛因素的纳入标准,最终筛选了29篇文献及综述。结论:术后反应和局部感染是主要术后疼痛原因;术后疼痛管理一方面包括出现疼痛前予以术前药物干预、心理干预、预防术中疼痛,另一方面包括出现疼痛后术后药物和非药物干预,其中镇痛类药物最有效,冰敷及抗菌漱口水可常规使用,抗生素、皮质固醇类药物特定情况下应用,其他干预方式尚需进一步研究。

The third molar extraction is a routine operation in the department of stomatology. Postoperative pain is an important cause of dental phobia. Purpose: To explore the causes of postoperative pain and whether the current postoperative pain management is consummate. Method: This study searched the literatures that were performed to identify articles from Jan. 1st 2014 to Jan. 1st 2020 using the following key words: third molar, tooth extraction, postoperative pain, pain management and pain intervention. Finally, 29 literatures and reviews were selected with an inclusion criterion that includes at least one factor related to postoperative pain after tooth extraction. Conclusion: Postoperative reactions and local infections were the main causes of postoperative pain. On the one hand, postoperative pain management includes preoperative drug intervention, psychological intervention before pain and prevention during operation. On the other hand, it also includes postoperative drug and non-drug intervention. Among them, analgesics are the most effective. Ice compress and antibacterial mouthwash can be used routinely. Antibiotics and corticosteroid drugs should be used under particular conditions. Other interventions need further study.