PRE-EMPTIVE ANALGESIA FOR THE SURGICAL REMOVAL OF IMPACTE MANDIBULAR THIRD MOLAR UNDER GENERAL ANAESTHESIA

Abstract

Pain is a common and frequent human experience, which is not only a concern to the sufferer, but also to society. Pain seriously impairs the lives of millions of people around the world Cl).

Poor pain control can increase patient's fear of treatment and increase their anxiety (2). Adequate pain relief should always be given a high priority in the management of any patient. It is not acceptable to discharge patients who may experience severe post-operative pain without providing sufficient analgesia C3 .

Surgical trauma activates the inflammatory process, which is a complex series of biochemical and cellular events involving a variety of inflammatory mediators which play a role in the propagation of pain, these include: prostaglandins, bradykinin and histamine 4 .

The surgical removal of impacted mandibular third molar teeth often produces pain, swelling and trismus, which are the acute post­ operative sequelae of inflammation due to tissue injury during the surgical procedure cs).

Nowadays, there is an increased trend for the surgical removal of impacted third molar teeth under general anaesthesia as a day case surgery c6 8 . One goal of modern anaesthesia is to ensure that patients having surgery awake from anaesthesia with excellent pain control and to maintain this control throughout the period of convalescence. Prevention, rather than treatment of severe post-operative pain is