Purpose: To compare three analgesic regimens for managing postoperative pain after dental restorative treatment under general anesthesia.
Methods: Prospective, randomized, double-blind study. Patients undergoing dental rehabilitation under general anesthesia were randomly assigned to one of three analgesia regimens: 1.0 mg/kg IV Toradol (ketorolac) alone, 1.0 mg/kg IV Toradol + 0.1 mg/kg IV morphine, or 1.0 mg/kg IV Toradol + 7mg/kg (max) 2% Lidocaine with 1:100,000 epinephrine local anesthetic infiltration. Postoperative pain was evaluated using standardized Faces-Legs-Arms-Consolability-Crying (FLACC) scale and the Wong-Baker FACES scale.
Results: Sixty-seven children were included in final data analysis. Upon pair-wise analysis, it was determined that the Toradol-Local Anesthetic group responded significantly better for the FLACC-discharge than the Toradol-Morphine group (p=.004). The Toradol-Morphine group performed significantly better for the 24 hour FACES score (p=.015) than the Toradol-Local Anesthetic group.
Conclusions: Postoperative regimen significantly impacted pain scores upon discharge and at twenty-four hour follow up.