scholarly journals A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures

2017 ◽  
Vol 10 (3) ◽  
pp. 171-174 ◽  
Author(s):  
Ankesh Dilip Jain ◽  
VSM Ravisankar ◽  
KSN Siva Bharani ◽  
KM Sudheesh ◽  
Nisha Tewathia
Keyword(s):  
Adverse Effects ◽  
Internal Fixation ◽  
Pain Intensity ◽  
Pain Control ◽  
Open Reduction ◽  
Opioid Analgesic ◽  
Maxillofacial Surgery ◽  
Analgesic Efficacy ◽  
Mandibular Fractures ◽  
Study Results

Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I–II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.

scholarly journals Mandibular Ramus Fractures: A Rarity

2013 ◽  
Vol 14 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Tejraj Pundalik Kale ◽  
SM Kotrashetti ◽  
Archana Louis ◽  
JB Lingaraj ◽  
BU Sarvesh
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Maxillofacial Surgery ◽  
Post Treatment ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Trauma Patients ◽  
Mandibular Ramus ◽  
Anatomic Reduction ◽  
Age Range

ABSTRACT Aim To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Materials and methods Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Results Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Conclusion Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. Clinical significance This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42.

scholarly journals Nasal/maxillofacial manifestations of head and neck injury

2017 ◽  
Vol 3 (3) ◽  
pp. 555
Author(s):  
Siddaram Patil ◽  
Girish P. B.
Keyword(s):  
Head Injury ◽  
Internal Fixation ◽  
General Anesthesia ◽  
Open Reduction ◽  
Mandibular Fractures ◽  
Medical College ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Waking Up ◽  
Head And Neck Injury

<p class="abstract"><strong>Background:</strong> A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">.</span></p>

Efficacy of open reduction and internal fixation in achieving bony union of comminuted mandibular fractures caused by civilian gunshot injuries

The Surgeon ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 214-218
Author(s):  
Saad-ud-din Siddiqui ◽  
Naveed Iqbal ◽  
Mirza Hamid Baig ◽  
Hassan Mehdi ◽  
Syed Mahmood Haider
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Bony Union ◽  
Mandibular Fractures ◽  
Gunshot Injuries

Switching From Morphine to Methadone to Improve Analgesia and Tolerability in Cancer Patients: A Prospective Study

2001 ◽  
Vol 19 (11) ◽  
pp. 2898-2904 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Alessandra Casuccio ◽  
Fabio Fulfaro ◽  
Liliana Groff ◽  
Roberto Boffi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Therapeutic Option ◽  
Oral Morphine ◽  
Oral Methadone ◽  
Before And After ◽  
Clinical Benefits ◽  
A Prospective Study

PURPOSE: To evaluate the clinical benefits of switching from morphine to oral methadone in patients who experience poor analgesia or adverse effects from morphine. PATIENTS AND METHODS: Fifty-two consecutive cancer patients receiving oral morphine but with uncontrolled pain and/or moderate to severe opioid adverse effects were switched to oral methadone administered every 8 hours using different dose ratios. Intensity of pain and adverse effects were assessed daily, and the symptom distress score (DS) was calculated before and after switching. RESULTS: Data were analyzed for 50 patients. Switching was considered effective in 80% of the patients; results were achieved in an average of 3.65 days. In the 10 patients who switched to methadone because of uncontrolled pain, a significant reduction in pain intensity (P < .005) and an average of a 33% increase in methadone doses necessary (P < .01) were found after an average of 3.5 days. DS significantly decreased from an average of 8.4 to 4.5 (P < .0005). In the 32 patients switching because of uncontrolled pain and morphine-related adverse effects, significant improvement was found in pain intensity (P < .0005), nausea and vomiting (P < .03), constipation (P < .001), and drowsiness (P < .01), but a significant increase in the methadone dose of an average of 20% (P < .004) was required. CONCLUSION: In most patients with cancer pain referred for poor pain control and/or adverse effects, switching to oral methadone is a valid therapeutic option. In the clinical setting of poor pain control, higher doses of methadone are necessary with respect to the equianalgesic calculated dose ratios previously published.

Interventional Therapies for Cancer Pain Management: Important Adjuvants to Systemic Analgesics

2007 ◽  
Vol 5 (8) ◽  
pp. 851-858 ◽  
Author(s):  
Anthony Eidelman ◽  
Traci White ◽  
Robert A. Swarm
Keyword(s):  
Pain Management ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Pain Control ◽  
Analgesic Efficacy ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Inflammatory Drugs ◽  
Control Pain ◽  
Interventional Therapies

Optimized use of systemic analgesics fails to adequately control pain in some patients with cancer. Commonly used analgesics, including opioids, nonopioids (acetaminophen and non-steroidal anti-inflammatory drugs), and adjuvant analgesics (anticonvulsants and antidepressants), have limited analgesic efficacy, and their use is often associated with adverse effects. Without adequate pain control, patients with cancer not only experience the anguish of poorly controlled pain but also have greatly diminished quality of life and may even have reduced life expectancy. Interventional pain therapies are a diverse set of procedural techniques for controlling pain that may be useful when systemic analgesics fail to provide adequate control of cancer pain or when the adverse effects of systemic analgesics cannot be managed reasonably. Commonly used interventional therapies for cancer pain include neurolytic neural blockade, spinal administration of analgesics, and vertebroplasty. Compared with systemic analgesics, which generally have broad indications for control of pain, individual interventional therapies generally have specific, narrow indications. When appropriately selected and implemented, interventional pain therapies are important components of broad, multimodal cancer pain management that significantly increases the proportion of patients able to experience adequate pain control.

scholarly journals Comparison of functional outcome after open and closed reduction of mandibular subcondylar fracture

2020 ◽  
pp. 1-12
Author(s):  
Samira Shabbir Balouch ◽  
Rana Sohail ◽  
Sadia Awais ◽  
Riaz Ahmad Warraich ◽  
Mir Ibrahim Sajid
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Subcondylar Fracture ◽  
Group A ◽  
Group B

Abstract Objective: To compare open reduction with internal fixation of mandibular subcondylar fracture with closed reduction in terms of adequate mouth opening. Method: The randomised clinical trial was conducted from March 2014 to February 2015 at the Oral and Maxillofacial Surgery Department, King Edward Medical University and Allied Hospitals, Lahore, Pakistan, and comprised patients who presented with unilateral subcondylar fractures. The patients were randomly divided into 2 groups. Group-A patients were treated with closed reduction and immobilisation and were discharged the same day, while Group-B patients were treated by open reduction with internal fixation and retained in ward for 1 day. Both were recalled for periodic follow-ups, and were compared in terms of achieving adequate mouth opening. Data was analysed using SPSS 20. Results: Of the 70 patients, 35(50%) were in each of the two groups. The mean age in Group-A was 28.88±11.86 years compared to 28.22±10.80 years in Group-B (p>0.05). Mean mouth opening in  the two groups were consistently positive, and significant at the last two follow-ups(p<0.001). Conclusion: The difference in results of both treatment modalities was significant, indicating that open reduction and internal fixation should be the preferred treatment. Key Words: Mandibular sub-condylar fracture, Open reduction, Closed reduction, Internal fixation, Mouth opening.

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