A Multimodal Analgesic Regimen Including Liposomal Bupivacaine Moderated Acute Pain Levels After Third Molar Surgery
Bibliographic record
Abstract
This prospective, observational study was designed to moderate post-surgerical acute pain with a multimodal analgesic regimen including liposomal bupivacaine implemented for patients having third molar surgery. We hypothesized that acute pain would be reported no higher than 50% of the maximum possible. Patients and methods: Inclusion criteria: ASA risk classification I or II, age 18-35 years, and at least two mandibular third molars below the occlusal plane. All subject-patients were enrolled after consent for surgery and treated with the multimodal analgesic regimen. Data at surgery were completed by patient and surgeon. Acute pain data were derived from a 14-day diary completed by subject-patients each Post-Surgical Day (PSD) for the past 24 hours. The primary outcome variable was subjects experiencing “worst pain” which was defined as the three highest values on a 7 point Likert scale. Secondary outcome variables were the time in number of days until “little or no pain” were recorded. This was defined as the two lowest values on the same Likert scale. We used descriptive statistics to report outcomes. Results: Data were from 50 subjects. Thirty-two (64%) were female, median age was 22 years (IQR 19y, 26y), 48% were Caucasian, 25% Latino, 17% African-American, 10% other ethnicity. Surgeons’ median estimate of degree of difficulty was 9 out of 28 (IQR 5,15). Median surgery time was 32min (IQR 20,40). Thirty-nine patients had maxillary third molars removed; 86%, were vertical or distoangular. Bone was removed from 35%. All had both mandibular third molars removed; 54% were mesioangular or horizontal. Bone was removed from 95%. Eleven (23%) patients reported worst pain on PSD1, 17 (35%) on PSD2, 18 (37.5%) on PSD3, and 12 (25%) on PSD4. By PSD6, half of the subject-patients reported little or no pain. Conclusions: Outcomes for pain after third molar surgery were moderated by the multimodal analgesic regimen including liposomal bupivacaine, but the goal of all reporting pain 50% of the maximum possible was not achieved.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".