Ketamine in Post-operative Dental Pain and Recovery
Status:
Completed
Trial end date:
2016-04-18
Target enrollment:
Participant gender:
Summary
Low dose sub-anaesthetic dose of ketamine has been shown to reduce postoperative pain and
analgesic consumption. However, due to the heterogeneous results, the standard dosing regimen
has not been available. Recently, its effect in postoperative outcomes and the development of
post-operative surgical pain has also been suggested.
Ketamine has been shown to reduce post-operative early inflammation especially serum IL-6.
Therefore, study in its effects in post- operative pain and outcomes due to inflammation is
suggested. Only few clinical studies assessed post-operative pain are related to
inflammation.
Pain after third molar surgery is a good model of postoperative acute inflammatory pain.
A previous study showed that there was no benefit to administer ketamine before or after oral
surgery for pain relief. However, other studies demonstrated that ketamine used as sedative
or local ketamine in third molar surgery could reduce postoperative dental pain, swelling and
trismus.
Postsurgical facial oedema is difficult to quantify accurately as it is three dimensional.
Over the years, various measurement techniques have been tried to measure oedema objectively.
These include direct linear measurement using tape or flexible rulers across fixed soft
tissue landmarks, standardized stereophotographic measurements, computerized tomography (CT),
magnetic resonance imaging (MRI), ultrasonography (US) and three - dimensional (3D) laser
scanning. Recently, three dimensional image reconstructions using a reversed engineering
technique has been developed and is used in the manufacturing industry. This technology could
be applied in a clinical setting for monitoring soft tissue changes.
In this study, the investigators will aim to study the use of sub-anaesthetic dose of
ketamine in post-operative dental pain and recovery outcomes.
The investigators hypothesise that post-operative pain after Bilateral Third Molar under
General Anaesthesia is less in patients receiving sub-anaesthetic does of ketamine before
incision. The magnitude of this effect will be compared with a positive control group
(dexamethasone) as well as a placebo group (normal saline). Further, the investigators aim to
demonstrate whether ketamine can reduce post-operative facial oedema and other post-operative
outcomes.