Pre-emptive analgesia for primary tooth extractions in children: systematic review of literature

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Abstract

Introduction: Pain is a subjective phenomenon that can evoke a sense of innate fear and anxiety. So, pain control should be the main stay of any treatment protocol in dentistry especially for children. Even though it is very well managed pre and intra operatively, a situation possibly arises post operatively. Administration of pre-emptive analgesia could be one of the methods used in the management of post operative pain. This systematic review aimed to evaluate the efficacy and safety of pre-emptive analgesia for primary tooth extractions in children.   Methods: PubMed, Ovid SP, Cochrane databases were filtered from years 1980 up to July 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria independently by two reviewers. Studies that compared pre-emptive analgesic administration in comparison with placebo for primary tooth extractions in children were evaluated. The outcome sought for were self-reported post-operative pain (patient perceived pain), total number of rescue analgesics consumed in the post-operative follow up period. Results: A total of six studies were included for the final evaluation. Most of the studies report lower self-reported post-operative pain scores(n=3), and lower rescue analgesic consumption(n=3), in pre-emptive group in comparison to placebo. Conclusions: Pre-emptive analgesic administration might have a positive effect on above mentioned parameters during primary tooth extraction in children, but more evidence is needed to justify the same.

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  1. This Zenodo record is a permanently preserved version of a PREreview. You can view the complete PREreview at https://prereview.org/reviews/10884627.

    The article reflects a controversial topic in dental practice that is necessary for the clinical decision-making of many dental professionals. 

    Best wishes to the authors….. Congrats !!

    Major issues

    • Any systematic review should start from a problem that is not clear in the introduction to the article.

    • The description of the problem could be more explanatory in the introduction section.

    • The example of formulation must be reproducible and correspond to that of one of the platforms used. (preferably for Pubmed)

    • The discussion mixes relevant results, which were not mentioned in the results section, with the contrast of similar results of other authors that could converge or disagree with the present research.

    Minor issues

    • The PRISMA guide argues that the objective should be a subsection of the article as it is introduction, methods, etc.

    • The question referred to at the beginning of the method is not posed as a question but as an affirmation.

    • The quality of the figures could be better.

    Competing interests

    The author declares that they have no competing interests.