Postoperative or preoperative medication? Which one is more effective in the management of postoperative extraction dental pain in children?

Alleviating a painful procedure like tooth extraction by compound analgesics in a single dose using the synergistic effects, particularly before the beginning of extraction pain, is favourable. The aim of the present study was to evaluate the beneficial effect of time (preoperative/postoperative) to prescribe medication in the management of postoperative dental pain following primary tooth extraction. The present double-blind clinical trial study included 121 healthy children aged 6-12 years old. The children were classified into four groups, including Group 1: Neurobion forte-vitamin B complex-vitamin B12 as placebo 30 minutes before extraction, Group 2: Neurobion forte-vitamin B complex-vitamin B12 30 minutes after extraction, Group 3: concurrent ibuprofen-acetaminophen combination 30 minutes before extraction, and Group 4: concurrent ibuprofen-acetaminophen combination 30 minutes after extraction. The researcher was blind about which group took placebo or main drug. Patient was blind too. The rate of pain was evaluated with visual analogue scale (VAS) immediately, 30 minutes after extraction, and 6 and 24 hours later. Data were collected and analyzed using SPSS software. T-test was used to compare between groups (P < 0.05). Repeated measures test was used to compare between the placebo and main drug groups during measurement times. Population of the study included 58 (47.9%) boys and 63 (52.1%) girls. It was found that mean pain intensity in group 3 was considerably lower than other groups immediately after intervention. Moreover, in group 2, it was significantly more than other groups. However, under 30 minutes, 6 hours, and 24 hours, repeated measures test showed that the mean severity of pain in group 2 was significantly more than other groups. According to the results, concurrentpreoperative ibuprofen-acetaminophen administration would provide better analgesic efficacy compared to the postoperative ibuprofen-acetaminophen combination in 6-12 years old children. Moreover, the effect of induction in children could be demonstrated.