Single oral dose of lysine clonixinate in postoperative dental pain

Lysine clonixinate (LC) is a cyclooxygenase inhibitor of moderate potency that not shows inhibition for longer period and greater extent in collagen-induced aggregation of platelet-rich plasma. LC inhibits in minor proportion TXB2 and PGF2 biosynthesis than acetylsalicylic acid and shows important analgesic activity. Objectives: The aim of the present pilot study was to test the efficacy of prior LC administration in the control of postoperative surgery pain. Methods: Twelve patients requiring exodontic therapy in asymptomatic teeth participated in this study. Informed consent was obtained prior to their participation. Tablets of a single dose of placebo (n=5) or lysine clonixinate 125 mg (n=7) were administered 15 min before local anesthetic administration and surgery. Pain intensity was evaluated by 100mm VAS at 0,3,4,6,8,9,10,12,18 and 24 hours after analgesic or placebo administration. Color VAS and accounting of rescue medication consumption (750 mg acetaminophen) were also recorded. Results: Treatment groups did not significantly differ in maximum arterial pressure (p=0.69); minimum arterial pressure (p=0.13); weight (p=0.54); age (p=0.38); volume of local anesthetic used (p=0.72) and surgery time (p>0.05). Statistical testing by ANOVA showed differences in pain scores between groups (p=0.0194). Between the 6, 12 and 24-hour investigation point, placebo-treated patients reported mild pain when compared to those treated with LC (p<0.05). SPID demonstrated that LC was effective in the control of the pain versus control (p=0.048). Using color VAS postoperative pain occurred in 60% of placebo and 28.57% of the patients treated with LC. There were significant differences between treatment groups with respect to the number of patients requiring rescue medication. Conclusions: These preliminary results suggest that moderate postoperative surgery pain can be partially controlled in asymptomatic teeth with pre-emptive lysine clonixinate administration and LC can be a clinic alternative in the pain management after dental surgery.