目的：研究口服非甾体类抗炎药洛索洛芬钠片在下颌阻生第三磨牙拔除术中超前镇痛的临床效果。方法：2017年6—8月北京大学口腔医院第一门诊部向拔除下颌阻生第三磨牙的患者发放术后疼痛调查问卷。根据患者实际初次口服洛索洛芬钠片的时机，患者被分为3组：未服药组（术前、术后均未口服洛索洛芬钠片）、术前服药组（术前30 min口服洛索洛芬钠片60 mg）和术后服药组（术后30 min口服洛索洛芬钠片60 mg）。统计指标为手术时间，术后2、4、12、24、48 h的疼痛视觉模拟评分 (visual analogue scales, VAS)，离院后服用洛索洛芬钠的人数以及药物不良反应。结果：3组手术时间均为15.0 （5.0,30.0） min,3组手术时间差异无统计学意义（P=0.848）。未服药组术后2、4、12、24、48 h的评分分别为1.75 （0.1，10.0）、6.25 （1.5，10.0）、2.00 （0.1，8.0）、2.00 （0.1,6.0）和0.5 (0.1,5.5)， 差异有统计学意义（P<0.001），术后4 h评分高于其他时间点（P<0.005）。在术后4 h，术前服药组评分［2.0 (0.1,10.0)］和术后服药组评分［2.0 (0.1,5.0)］均低于于未服药组评分［6.25 （1.5,10.0）］，差异有统计学意义（P<0.001）。离院后服用洛索洛芬钠片的人数未服药组9人（40.9%），术前服药组5人（21.8%），术后服药组7人（33.3%）。术前服药组药物不良反应发生率（3/23，13.0%）和术后服药组药物不良反应发生率（4/21，19.0%）低于未服药组药物不良反应发生率（8/22，36.4%）。结论：两种超前镇痛的方案，即术前30 min口服洛索洛芬钠片60 mg和术后30 min口服洛索洛芬钠片60 mg，在下颌阻生第三磨牙拔除中都可以有效减轻术后疼痛。

Objective：To investigate the effectiveness of preemptive analgesia with loxoprofen sodium orally, which was a kind of non-steroid anti-inflammatory drugs, in extractions of mandibular impacted third teeth. Methods: There were questionnaires about postoperative pain for patients whose mandibular impacted third teeth were extracted from July 2017 to August 2017 in First Clinical Division of Peking University School and Hospital of Stomatology. All the patients did their routine clinical examinations and imaging examinations. After their mandibular impacted third teeth were extracted, the questionnaires were sent to them. The questionnaires were filled in by the patients on their own and returned one week later. There were 120 questionnaires that were sent and 105 questionnaires returned, of which 98 questionnaires were filled in completely. According to the inclusive criteria and exclusion criteria, 66 questionnaires were totally selected in this study. According to the time when the patients took their loxoprofen sodium orally firstly, the patients were divided into 3 groups. The first group was for patients who didn’t take loxoprofen sodium during their extractions (non-medicine group). The second group was for patients who took 60 mg loxoprofen sodium 30 min before their extractions (preoperative group). The third group was for patients who took 60 mg loxoprofen sodium 30 min after their extractions (postoperative group). The operation time among the 3 groups was analyzed by Kruskal-Wallis method. The postoperative time points were 2, 4, 12,24 and 48 h after operation. The scores of visual analogue scales (VAS) for postoperative pain in each group at different postoperative time points were analyzed by Friedman method. At each postoperative time point, VAS scores in the different groups were analyzed by Kruskal-Wallis me-thod. The numbers of the patients taking loxoprofen sodium home and drug adverse reactions were also analyzed. Results: The operation time of the 3 groups was 15.0 (5.0,30.0) min and had no significant differences (P=0.848).VAS scores of non-medicine group 2,4, 12,24 and 48 h after operation were 1.75 (0.1,10.0), 6.25 (1.5,10.0), 2.00 (0.1,8.0), 2.00 (0.1,6.0) and 0.5 (0.1,5.5) separately and had significant differences (P<0.001).The VAS score at 4 h after operation was higher than the VAS scores at other time points after operation (P<0.005). Four hours after the operations, the VAS scores of preoperative group ［2.0 (0.1,10.0)］ and postoperative group ［2.0 (0.1,5.0)］ were lower significantly than those of non-medicine group ［6.25 (1.5,10.0)］ (P<0.001).The numbers of the patients taking loxoprofen sodium home were 9(40.9%) in non-medicine group,5(21.8%) in preoperative group and 7(33.3%) in postoperative group. The number of the patients who had drug adverse reactions in preoperative group (n=3,13.0%) and in postoperative group (n=4,19.0%) was less than the number of the patients who had drug adverse reactions in non-medicine group (n=8,36.4%). Conclusion: There were two protocols of preemptive analgesia with loxoprofen sodium orally in extractions of mandibular impacted third teeth, which were taking 60 mg loxoprofen sodium orally 30 min before the extractions and taking 60 mg loxoprofen sodium orally 30 min after the extractions. Both of the two preemptive analgesia protocols could decrease the postoperative pain significantly.