Analgesics in combination with gabapentin just as effective as opioids for dental pain

A combination of analgesics prescribed with gabapentin after dental procedures was shown to be just as effective for treating pain as opioids, researchers reported in JAMA Network Open.

Qirong Huang, DDS, MS, of the Eastman Institute for Oral Health at the University of Rochester Medical Center in New York, and colleagues conducted a cross-sectional survey to assess whether a multimodal analgesia strategy with nonsteroidal anti-inflammatory drugs for managing pain is as effective as opioids.

“We hypothesized that using a combination of the non-opioid pain medications and adding gabapentin to the mix for pain would be an effective strategy to minimize or eliminate opioids for dental pain,” Yanfang Ren, DDS, PhD, MPH, co-author of the study, said in a press release from the university.

Huang, Ren and colleagues used prescription data from March 2021 to February 2022 to represent prescription patterns in 2022 and from 2012 to represent patterns prior to opioid reduction.

A total of 3,357 patients (51.1% female; mean age, 36 years) were prescribed analgesics after dental extraction in 2012, compared with 3,785 (51.3% male; mean age, 39 years) in 2022. The rate of nonopioid multimodal analgesia use was higher in 2022 (62.5%) than in 2012 (0.2%).

In total, 1,166 patients (34.7%) received opioid combination analgesics in 2012. In 2022, no patients received opioids, but 1,871 (49.4%) received acetaminophen/ibuprofen, and 496 (13.1%) received gabapentin multimodal analgesia.

According to the authors, acetaminophen/ibuprofen had a failure rate (2.2%) that was significantly lower than gabapentin/acetaminophen or gabapentin/ibuprofen (4.4%; RR, 0.50; 95% CI, 0.31-0.83) and that of opioids (21.4%; RR, 0.10; 95% CI, 0.08-0.14). The failure rate for multimodal analgesia including gabapentin was significantly lower than it was for opioids (RR, 021; 95% CI, 0.14-0.31).

“This study represents continued efforts by our team and other dentists to minimize the use of opioids for dental pain,” co-author Eli Eliav, DMD, PhD, said in the release. “Additional studies, preferably randomized controlled clinical trials, are needed to confirm the safety and effectiveness of this approach. It is our duty to continuously seek safe and effective treatment for our patients in pain.”

Reference:

New Eastman Institute study shows promising alternative to opioids for pain after tooth extractions. https://www.urmc.rochester.edu/news/story/new-eastman-institute-study-shows-promising-alternative-to-opioids-for-pain-after-tooth-extractions. Published Aug. 17, 2022. Accessed Aug. 19, 2022.