Biology, asked by DvDeora9162, 1 year ago

why pentazocine is administered with promethazine

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Answered by ommritishkumar
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The control of pain and anxiety is an essential part of dental practice. Many strategies are used to achieve this goal, including psychological approaches, local anesthetics, and sedatives and general anesthetics, individually or in combination. The choice of the modality for a particular situation is based on the training, knowledge, and experience of the maxillofacial surgeon, the medical status of the patient, and the psychological and dental needs of the patient. Therapeutic basis of alleviating anxiety is based on using pharmacological means.

In this age of anxiety, pain control and sedation have become important aspects of dental care. The use of sedation for dental care has become a topic of intense interest. Anxiety and pain are intimately related. Anxiety can also lead to the exacerbation of pain. Anxious patients were uncooperative during surgery and complicate the procedure.

Due to the compatibility of promethazine and pentazocine in the single syringe, similarity in the duration and onset of action, the safety of the drugs and cost effectiveness; the combination of promethazine and pentazocine as sedatives and pain control has been used widely in different surgical procedures along with local anesthetic.

Despite the increased drowsiness with promethazine, there was no delay in discharge of the patients and sedation was higher in promethazine group when compared with placebo. Our study showed that promethazine–pentazocine drug combination of group 1 is more advantageous significantly as compared to placebo of group 2, to achieve sedation and to relieve anxiety preoperatively.

Clinical effects of promethazine and pentazocine are generally apparent within 20 min of an intramuscular injection. Duration of action is 4–6 h, although effects may persist up to 12 h. Patients allocated promethazine were tranquil or asleep by 20 min.

Eventhough the drug combinations of promethazine and pentazocine have been used extensively in different surgical procedures, a particular study has not been found especially in oral and maxillofacial surgery. In our study, we compared the sedative and analgesic effects of fortwin–phenergan to the effects of normal saline placebo for the surgical extraction of mandibular third molar in anxious patients. The aim of our study is an attempt to reduce the patient’s anxiety and relieve pain.

It is well documented that placebo is associated with powerful non specific effects. Some studies have shown that placebos have healing effects in conditions like angina pectoris, control of nausea and vomiting. Chia in 2004 stated that there was no difference in the sedative effects between promethazine and placebo (normal saline) Parlow et al. concluded that sedation was higher in promethazine group than placebo group. In our study, it was found that the sedative effect of promethazine was higher than placebo group which is highly significant (P value = 0.00).

The present clinical study was designated to evaluate the usefulness of intramuscular conscious sedation of promethazine hydrochloride and pentazocine along with 2 % lidocaine hydrochloride and adrenaline, and comparison to normal saline as placebo with lidocaine hydrochloride and adrenaline in anxious patients for the surgical removal of mandibular third molar.

Patients were selected randomly from the out patient Department of Oral And Maxillofacial Surgery, Regional Dental College Guwahati; Assam. The surgery was carried out under local anesthesia using 2 % lidocaine with 1:80,000 adrenalin.

Sixty patients were selected using Corah Dental Anxiety Scale having a score of more than 13 which indicates anxious patients and were randomly divided into group 1 and group 2 with 30 patients in each group. Patients were randomly selected irrespective of caste, sex, race and religion and were between 18 and 60 years of age.
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