PREOPERATIVE, PERIOPERATIVE, AND POSTOPERATIVE ANALGESIA PROTOCOLS IN ORAL SURGERY: A MULTIMODAL AND EVIDENCE-BASED APPROACH

Resumen

Effective pain management is a cornerstone of successful outcomes in oral and maxillofacial surgery. Among the most common procedures requiring a structured analgesic protocol is the extraction of impacted third molars, which often leads to postoperative pain, edema, and trismus. This paper presents a comprehensive review of analgesia strategies employed in the preoperative, perioperative, and postoperative phases, with a focus on evidence-based, multimodal approaches aimed at optimizing patient comfort and minimizing complications. Preoperative analgesia aims to reduce the intensity of pain before it begins, typically involving the administration of non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to decrease inflammatory responses. The perioperative phase emphasizes the use of local anesthetics—such as lidocaine with epinephrine—to ensure effective intraoperative pain control and hemostasis. In some cases, conscious sedation may be indicated depending on the patient’s anxiety level and procedural complexity. Postoperative analgesia combines pharmacological agents such as NSAIDs and acetaminophen to manage pain, with short-term use of opioids considered in cases of severe discomfort. Recent studies support the use of multimodal analgesia protocols to provide superior pain relief while reducing reliance on opioids, thus minimizing adverse effects such as nausea, constipation, or dependence. Tailoring these protocols to patient-specific factors—such as medical history, allergies, or pain thresholds—further enhances safety and efficacy. This review also highlights the growing importance of individualized care plans, as well as the need for proper patient education to improve adherence to analgesic regimens. Collectively, the integration of preemptive analgesia, optimized intraoperative anesthesia, and structured postoperative care forms a robust strategy for improving surgical experiences and patient satisfaction in oral procedures.