Acetaminophen pre-treatment for Closed Nose Reduction under local
anesthesia: a triple-blind placebo-controlled randomized clinical trial
Abstract
Background: Nasal bone fracture is the most common facial fracture
(approximately 40 % of all the facial fractures) and is mostly treated
with closed reduction. It is performed either with general or local
anesthesia. Local anesthesia is fast and cheap but pain can’t be fully
suppressed. We designed this study to see if pre-emptive analgesia with
Acetaminophen can reduce the pain associated with nasal reduction under
local anesthesia. Methodology/Principal: in this triple-blind randomized
clinical trial we had 100 participants divided into two arms (either
placebo or Acetaminophen 500 mg Tablet 45 minutes before reduction).
Medication was randomly delivered via packages and the surgeon,
patients, and data analyzer were all unaware of the nature of the
medication. Then demographic data along with VAS pain scores (1-10 score
from least to most severe pain) during local anesthesia, during
reduction, and 24 hours after reduction were analyzed. Results: The
patients were mostly men (74%) and the most common mechanism was
involvement in fight. (30%). Left depression was the most seen type of
fracture (53%). Pain scores as well as surgeon satisfaction analysis
returned no statistical difference between the two groups. Correlation
analysis was done and the only factor for pain severity during reduction
was the number of tries needed. Conclusions: Acetaminophen pre-treatment
can’t add analgesia any more than that of Placebo. Its use before
reduction of nasal bone is not justified