Analgesia in Dentistry
Situation I.
A healthy young patient attends dental surgeon. Patient is scheduled to extraction of stored horizontally impacted lower third molars. We explain the patient a surgical intervention in local anaesthesia, procedure itself and post-operative care, familiarize him with the strategy of so-called preemptive analgesia. What is it?
Repeated application of local anesthetics in the aftermath of the initial dose, resulting in greatly reduced consumption of analgesics in the postoperative period.
The concept of preemptive analgesia is mentioned only in connection with general anaesthesia. Use of analgesics as premedication reduces anaesthetic dose, potentiates the analgesic component of general anaesthesia and provides analgesia in the postoperative period. Preemtive analgesia is not used in connection with the procedure performed under local anaesthesia.
In the case of a small outpatient surgery, administration of analgesics, anti-inflammatory drugs approximately one hour prior to surgery in order to ensure better painrelief once the local anesthetic has worn off.
The physical method of analgesia with aim of reducing the temperature of the operated area (in our case, icing the faces in the mandibular body about an hour before the surgery). Vasoconstriction and reduced blood flow leads to decreased reactivity of nociceptive receptors.