Does the pre‐emptive administration of paracetamol or ibuprofen reduce trans‐ and post‐operative pain in primary molar extraction? A randomized placebo‐controlled clinical trial

Background There is no consensus whether the pre‐emptive administration of analgesics reduces trans‐ and post‐operative pain in primary molar extraction. Aim Investigate whether the pre‐emptive administration of ibuprofen and paracetamol reduces trans‐ and post‐operative pain on primary molars extraction compared to placebo. Design A parallel, placebo‐controlled, triple‐blind, randomized clinical trial was conducted. Forty‐eight children who needed primary molar tooth extraction were selected and treated under local anaesthesia and pre‐emptive administration of placebo or analgesics. Self‐reported pain was evaluated during the anaesthesia, extraction, and 2, 6, and 24 hours of post‐operative period, using a visual analogue scale (VAS). Children's baseline anxiety, behaviour during the procedure, parents' anxiety, and post‐operative analgesia were also assessed. Data analysis included descriptive statistics and multiple linear regression. Results No association was found between the use of pre‐emptive analgesic and lower scores of trans‐ and post‐operative pain compared to placebo. Children who presented negative behaviour reported greater pain during anaesthesia (P = .04) regardless of pre‐emptive analgesia group. Children from the placebo group were more likely to need post‐operative analgesia at 2 hours of follow‐up (P = .03). Conclusion The pre‐emptive administration of analgesics did not significantly reduce trans‐ and post‐operative pain in children after primary molars extraction.