Topische Applikation von Lokalanästhetika und Opioiden nach elektiver Zahnextraktion

Abteilung für Anästhesiologie und Allgemeine Intensivmedizin LKH Klagenfurt St. Veiter Str. 34 9020 Klagenfurt Österreich
Der Schmerz (Impact Factor: 1.5). 05/2005; 19(3):195-200. DOI: 10.1007/s00482-004-0334-2

ABSTRACT Ziel dieser Studie war es, die periphere Opioidwirkung bei elektiven Eingriffen im Mund-Kiefer-Bereich nachzuweisen und zu untersuchen, ob Morphinsulfat plus Lidocain, lokal postoperativ als Spray verabreicht, eine bessere analgetische Wirksamkeit erzielt als Lidocain allein.60 Patienten wurden doppelblind, randomisiert in die Studie eingeschlossen. Die Patienten hatten properativ keinen Schmerz und keine Entzndung (Zahnextraktionen) und erhielten bei Schmerzen als Ausweichmedikation Diclofenac retard 50mg oder Tramadol; Nebenwirkungen wurden dokumentiert.Weder in den demographischen Daten, der visuellen und numerischen Analogskala in den ersten 24h, noch im Analgetikaverbrauch konnte ein Unterschied zwischen beiden Gruppen festgestellt werden.Da die Patienten schmerzfrei zur Operation kamen, scheint es zu keiner Aktivierung der peripheren Opioidrezeptoren zu kommen. Deshalb konnte eine periphere Opioidwirkung in diesem Modell nicht belegt werden.The aim of this study was to provide evidence for the peripheral effect of opioids in oromaxillary procedures and to investigate whether postoperative morphine sulfate plus lidocaine administered as a local spray achieve better analgesic efficacy than lidocaine applied alone.The double-blind randomized study included 60patients. The patients exhibited neither preoperative pain nor inflammation (tooth extractions) and when pain occurred received as alternative medication diclofenac retard 50mg or tramadol. Side effects were documented.No differences between the two groups were observed in the demographic data, visual and numeric analog scale in the first 24h, or in the consumption of analgesics.Since the patients presented in a pain-free state at the time of surgery, apparently no activation of the peripheral opioid receptors occurs. Thus, a peripheral effect of opioids could not be demonstrated in this model.

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