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Use Of Tapentadol For Dental Surgery And Other Postsurgical Pain Management

Use Of Tapentadol For Dental Surgery And Other Postsurgical Pain Management

 

Tapenatdol is a strong and well-tolerated opioid analgesic that can treat moderate to severe postoperative pain within 30 minutes of intake. Its use as a pre-operative or perioperative analgesic has also been shown to be effective in several clinical studies. It helps in managing postsurgical pain through its dual mechanism of action, combining opioid receptor agonism and noradrenaline reuptake inhibition.

 

 

Postoperative pain management is one of the most important aspects for surgical patients. Medications that are often prescribed to control postsurgical pain are opioids and nonsteroidal anti-inflammatory drugs (NSAIDs). In this blog, we focus on evaluating the therapeutic efficacy and potency of one such opioid pain medication- Tapentadol. 

 

Overview Of Tapentadol 

Tapentadol is a centrally active opioid analgesic with a dual mode of action, thus significantly differentiating it from other commercially available pain medications. It is not available as a generic medication and is retailed under the brand names Aspadol, Palexia, and Nucynta. The use of Tapentadol IR, or the immediate-release formulation for minor oral surgery, has been established in many clinical studies. 

Opioid pain medication acts as an agonist at the opioid receptors in the central nervous system. The use of Tapentadol IR is to treat discomfort associated with migraine, lower back pain, and other acute pain. It has a quicker disintegration formulation and works for 5 to 6 hours after its ingestion. 

 

What Kinds Of Pain Will I Feel After Surgery?

Body pain associated with surgery is often acute pain and goes away with time as the area of the incision heals. Apart from the site of surgery, body pain is often left in the other part of the body as well. Thus, following surgery, you may or may not feel the following-

  • Muscle pain in the shoulder, neck, or chest due to lying on the operation table. 

  • A feeling of a sore or scratchy throat. 

  • Any body movement may increase the intensity of the pain at or around the incision site. 

Two specific types of postsurgical pain include-

  • Neuropathic Pain- This is caused due to damage to the nerve cells during the surgery. The use of Tapentadol for treating neuropathic pain is approved by the FDA and is an effective pain management option. 

  • Phantom Limb Pain- This pain is associated with amputation surgery, where the person feels a sensation in the part of the body that has been amputated or removed. 

 

Tapentadol Use In Clinical Dentistry And Other Post-Operative Pain 

 

tapentadol-use-in-clinical-dentistry

 

About 20 percent of patients experience severe pain in the first 24 hours following surgery, thus making it very crucial for effective pain management. 

Tapentadol For Dental Pain 

Clinical studies have shown the efficacy of Tapentadol in managing postsurgical dental pain. One such study was by Regina Kleinert, published in 2008, which indicates that a single oral dose of Tapentadol 75 mg or higher can effectively help reduce moderate-to-severe postoperative dental pain. The study also suggests that Tapentadol is a well-tolerated treatment option compared to morphine [1]. 

Another study done at the Department of Oral and Maxillofacial Surgery suggests that Tapentadol can be used for the management of mild-to-moderate pain following a mandibular third molar surgery [2]. 

Dr. Peter Barton, a General practitioner, described Tapentadol as a better option for managing dental pain in a letter addressed to the editor of the website australianprescriber [3]. Its role in postoperative pain management was also established in a study that suggested that the use of Tapentadol was effective in reducing acute postoperative pain and perioperative analgesic requirements, an analgesic that is used to prevent severe pain following surgery. 

In comparison, a study by Elliot V. Hersh et al. suggests that Tapentadol is less effective compared to 400 mg of ibuprofen in treating postsurgical dental pain and thus should be used as a second-line of pain management for postsurgical dental pain [4]. 

For Orthopedic Surgery

The efficacy of Tapentadol IR in reducing acute pain intensity associated with orthopedic surgery was established by a 2014 study by Y. K. Lee et al. in South Korea. 

Following A Cardiac Surgery

A Tapentadol and Tramadol comparison study by Srinivas Kalyanaraman Iyer et al. for pain management after a cardiac surgery suggests that Tapentadol is a much better analgesic choice than Tramadol due to its mu agonist activity and norepinephrine reuptake inhibition properties. 

Tapentadol Use For Bunionectomy Surgery

The use of Tapentadol for pain following bunionectomy is seen to be as effective as oxycodone but with a better safety profile in a 2008 study by Jens-Ulrich Stegmann et al. This is a surgery that is done to realign the bones of the foot,  cutting or “releasing” tight soft tissue structures and removing the bunion. 

 

Tapentadol For Pre-operative Pain Management 

Opioids have been a standard perioperative (time around a surgery) analgesic. The use of Tapentadol as a pre-operative or a perioperative analgesic is seen in a 2023 study by Stephanie C Ternel Lebret, which shows that the use of the analgesic is very effective and is associated with lower cases of sleepiness and other serious breathing impairments [5]. 

 

Advantages Of Using Tapentadol As A Pre And Post-Operative Analgesia 

Some of the key advantages of taking Tapentadol as your choice of analgesic before or after a surgical procedure are listed below. 

  • Safer Option for Patients with Liver Disorder- Tapentadol medication is not metabolized extensively in the liver through phase I metabolism. It minimizes the level of serotonin in the brain, thus not requiring metabolism to be active. It is, therefore, a better choice of analgesic with people with liver disorders. 

  • Quicker Onset of Action- The use of Tapentadol starts to act within 30 minutes of intake. 

  • Dual mechanism of action- Its mode of action makes it a better and quicker choice of analgesic. 

  • Improved Gastrointestinal Tolerability Profile- Studies evaluating the clinical efficacy and safety of Tapentadol IR for postoperative pain demonstrate that the medication is associated with an improved gastrointestinal tolerability profile compared to oxycodone. 

 

Tapentadol Dosage Guidelines For Postoperative Pain 

Tapentadol 100 mg is the standard dose of the medication that is seen to be more effective for patients with other opioid tolerance for severe pain. It can be taken every 4 to 6 hours, depending on the intensity of the pain. 

On the first day of the treatment, up to 700 mg/day can be administered. Whereas, from the second day, it should not be taken over 600 mg in a day. 

 

Potential Risks And Considerations

  • People prescribed Tapentadol as pre-surgical pain medication must stop the intake of medication with Aspirin and Ibuprofen-containing medication one week prior to taking Tapentadol. 

  • The common side effects of Tapentadol include vomiting (18%), nausea (30%), dizziness (24%), and somnolence (15%). 

  • Sudden discontinuation of the treatment is not advisable as it might result in withdrawal symptoms. It is advisable to follow the tapering method for Tapentadol, which includes a gradual lowering of the dosage. This allows the body to adjust to the lower doses of the medication before complete discontinuation. 

  • The use of Tapentadol is not advisable for patients with kidney and heart disorders without consulting a doctor. 

  • Its use is contraindicated in patients with a history of allergic reactions. 

  • The use of Tapentadol is not recommended for people with a history of abuse and addiction. 

  • Pregnant and lactating women must refrain from taking this opioid analgesic.

  •  It should not be given to people above the age of 65 years and to children below 17 years. 

  • Long-term use of Tapentadol is not advisable as it may increase the risk of experiencing dependency. 

 

Managing Postoperative Pain At Home

managing-postoperative-pain-at-home

During the time of your discharge, your surgeon will give you prescription pain medication for effective pain management at home. In most cases, you will be prescribed Tapentadol brand drugs, as its generic form is not available in the market. Along with the intake of your prescription pain medication, here are a few additional steps that will help you with better pain management at home. 

  • Before doing any physical activity, it is advisable to take your medication, most preferably in the morning and at bedtime. Like most medications, the Tapentadol IR tablets should be taken with a dosage gap of 4 to 6 hours and can be administered three to four times a day. 

  • Ensure that you get enough rest throughout the day. 

  • The use of alternative methods, such as heating or cool pads, can help with achieving better relief from pain. 

  • You can also use pillows for support while sleeping. 

 

Our Final Thoughts On The Use Of Tapentadol For Dental Surgery And Other Post-Operative Pain 

Postoperative pain is caused by damage to the peripheral nerves, meaning that the resulting pain is not located near the surgical site. With a dual mechanism of action it helps in managing moderate to severe pain associated with surgery within 30 minutes of intake.  

The use of Tapentadol is effective in treating postoperative pain associated with dental surgery, cardiac surgery, orthopedic surgery, and many others based on the diagnosis made by your doctor. 

Before getting Aspadol 100 mg tablets, the popular and affordable brand drug of Tapentadol, it is important to take its health risks into consideration. It is advisable to consult a doctor before taking Tapentadol for pain management.


FAQ's

Along with Tapentadol, the other postoperative analgesics recommended are morphine, fentanyl, and hydromorphone (Dilaudid).

Yes, the use of Tapentadol will help with managing toothache within 30 minutes of intake.

Three of the best pain medications to manage pain associated with dental surgery include Tapentadol, ibuprofen, and morphine.

People who are pregnant, breastfeeding, over the age of 65, children below 17 years, people with a history of abuse, and people with kidney and heart disorders. Even though it is a much safer option for people with hepatic issues compared to other opioid analgesics, it is not completely safe. Thus, it is recommended for such people to consult a doctor before taking Tapenatdol before taking Tapenatdol dosage.


References-

  1. Single dose analgesic efficacy of tapentadol in postsurgical dental pain: the results of a randomized, double-blind, placebo-controlled study, NCBI. 

  2. A comparative clinical evaluation of analgesic efficacy of Tapentadol and ketorolac in mandibular third molar surgery, NCBI. 

  3. Managing dental pain in general practice, australianprescriber.tg.org.au. 

  4. Using Tapentadol Hydrochloride in Clinical Dentistry, cdeworld. 

  5. Considerations for perioperative opioid analgesic stewardship in Australia: a focus on Tapentadol, PubMed.