Preoperative Administration of Jidabokuippo, a Kampo Medicine, Alleviates Postoperative Pain after Tooth Extraction with Mandible Bone Removal under General Anesthesia: A Prospective, Single-blind, Randomized Controlled Trial

Objective: This study aimed to determine the efficacy of preoperative administration of Jidabokuippo (JDI), a Kampo medicine, in treating postoperative pain after tooth extraction with mandible bone removal. Design: This single-blind, randomized controlled study was conducted among two groups of adult patients who were scheduled to undergo tooth extraction with mandible bone removal under general anesthesia. Patients were randomly assigned to either the JDI or control group. Intervention: Before surgery, the JDI group received JDI (7.5g), whereas the control group did not receive any treatment. Patients and the evaluator were blinded to the treatment status. At 0, 1, 3, and 24h after anesthesia recovery, an investigator recorded the severity of postoperative pain and nausea using a numeric rating scale (0, no pain or nausea; 10, worst imaginable pain or nausea). The number of patients who requested nonsteroidal anti-inflammatory drug (NSAID) and that of additional NSAID administration within 24h from anesthesia recovery, and the time to the first NSAID request from anesthesia recovery was also measured. Results: The severity of postoperative pain was significantly lower in the JDI group compared with the control group at 3 and 24h after anesthesia recovery (p<0.001 each). Both the number of patients requesting NSAID and additional NSAID administration after anesthesia recovery were significantly smaller in the JDI group than in the control group (p=0.006, p<0.001). The time to first NSAID request from anesthesia recovery was significantly longer in the JDI group compared with control group (p<0.001). The severity of nausea did not differ significantly between the groups. No significant side effects related to JDI were noted during the trial. Conclusions: JDI administration before general anesthesia effectively decreased the severity of postoperative pain after anesthesia recovery in patients who underwent tooth extraction with mandible bone removal.