Abstract | U dentalnoj medicini bol je česta pojava kod upalnih procesa u i oko zuba te nakon nekirurških i kirurških zahvata. U stomatognatnom sustavu najčešće je povezana sa zubom, parodontnim tkivima, mekim tkivima, mišićima te živcima, a izazvana je upalom, infekcijom ili traumom. Najčešće se radi o akutnoj boli koju je potrebno kontrolirati kako bi se izbjegla pojava kronične boli. U tu svrhu u prvom redu se koriste analgetici. Odabir analgetika ovisi o intenzitetu boli odnosno o vrsti zahvata te o indikacijama i kontraindikacijama lijeka. Kreće se nižim dozama (ibuprofen 200 – 400 mg ili paracetamol 500 mg) koje se po potrebi postepeno povećavaju do maksimalne dnevne doze. Za trudnice, djecu i starije osobe lijek izbora je paracetamol, a kod zdravih odraslih osoba to je ibuprofen. Kod posebnih skupina pacijenata doze lijeka je potrebno prilagoditi. Ukoliko ovi analgetici nisu dovoljno učinkoviti ni nakon povećanja doze do maksimalne dnevne doze, moguće ih je propisati u kombinaciji ili uvesti u terapiju i opioid prema protokolu. To se smatra djelotvornim obzirom da ti lijekovi imaju različit mehanizam djelovanja. Analgezija koja se postiže pomoću dva ili više analgetika naziva se multimodalnom analgezijom. Analgetike je moguće uzeti i prije odnosno neposredno nakon dentalnog zahvata u svrhu sprječavanja razvijanja i nastanka postoperativne boli što se naziva preemptivnom odnosno preventivnom analgezijom. |
Abstract (english) | In dental medicine, pain is a common companion of dental tissue inflammatory processes after non-surgical and surgical procedures. Within the masticatory system, it is the most commonly associated with the dental tissues, periodontal tissues, mucosa, muscles, and nerves, and is caused by inflammation, infection, or trauma. Most often, it is an acute pain that needs to be controlled to avoid chronic pain. For this purpose, analgesics are primarily used. The choice of analgesics depends on the intensity of the pain or the type of procedure performed, as well as the indications and contraindications of the drug administration. The treatment should always start with lower doses (ibuprofen 200 - 400 mg or paracetamol 500 mg), gradually increasing it to the maximum daily dose level as needed. For pregnant women, children and the elderly, the drug of choice is paracetamol, and in healthy adults, it is ibuprofen. For specific patient groups, dosage adjustments are required. If these analgesics are not effective enough after reaching the maximum daily doses, they can be prescribed in combination with opioids, according to protocol. This is considered effective because these drugs have different mechanisms of action. Analgesia achieved by two or more analgesics is called multimodal analgesia. Analgesics can be taken before or just after the dental procedure to prevent the development or onset of postoperative pain, which is called preemptive or preventive analgesia. |