RESUMO
Introduction: Periodontal procedures can promote prolonged intense pain, particularly in clinical situations requiring surgical procedures. In this context, preemptive analgesia has also been assessed for its utility in controlling post-operative pain and discomfort in patients undergoing periodontal invasive procedures. This study assessed the efficacy and safety of preemptive oral analgesia with steroidal and non-steroidal anti-inflammatory drugs in periodontal surgeries. Methods: This systematic review performed a search in the following electronic sources: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Virtual Health Library and in clinical trials electronic databases for relevant randomized clinical trials (RCTs); published up to July 2023. Primary outcomes assessed were post-operative pain, edema and trismus. A narrative synthesis of the findings was carried out. Results: Six RCTs, involving a total of 250 participants, were included. The studies reviewed had a high risk of bias, particularly due to allocation concealment and blinding of participants and personnel. The RCTs reported only the outcome pain. The preemptive use of dexamethasone 8 mg, etoricoxib 90 mg or 120 mg and ketorolac 20 mg seems to be more effective for controlling post-operative pain than placebo. Discussion: The anti-inflammatory drugs evaluated proved to be effective for controlling post-operative pain. However, given the limitations regarding lack of studies, methodological biases, disparities in drugs and doses, report restricted the pain outcome; further RCTs confirming the effectiveness and safety of these drugs in periodontal surgical procedures are warranted.
RESUMO
O autor ressalta duas concepções de memória na obra freudiana, correspondentes aos escritos de antes e depois de 1920, e discorre sobre suas relações com o prazer, a satisfação e o desejo, relações que se depreendem da caracterização do processo primário como visando a identidade de percepção. Tomando a dependência à droga como paradigma da adicção, problema especialmente presente na contemporaneidade, mostra como a neurociência permite ligar a adicção ao efeito da dopamina, hormônio da euforia, e à memória das intensas sensações de prazer promovidas pela droga. A satisfação proporcionada pela droga, entretanto, é a única alternativa ao gozo fálico, aquele que se satisfaz no exercício da fala e que tem lugar dentro do laço social.
The author emphasizes two conceptions of memory in the Freudian theories, before and after 1920, and discusses their relationships to pleasure, satisfaction and wish, relationships that are characteristic of the primary psychic processes, which seek the identity of perception. Taking drug dependency as a paradigm of addictions, a problem especially present in contemporariness, the author shows that neuroscience links addiction to dopamine, the hormone of euphoria, and to the memory of the intense pleasure sensations promoted by the drug. The satisfaction promoted by the drug, however, is the only alternative to the phallic jouissance, which is the one that is satisfied in the exercise of speech and that happens inside the social bond.
Assuntos
Humanos , Psicanálise , Dependência Psicológica , MemóriaRESUMO
O autor ressalta duas concepções de memória na obra freudiana, correspondentes aos escritos de antes e depois de 1920, e discorre sobre suas relações com o prazer, a satisfação e o desejo, relações que se depreendem da caracterização do processo primário como visando a identidade de percepção. Tomando a dependência à droga como paradigma da adicção, problema especialmente presente na contemporaneidade, mostra como a neurociência permite ligar a adicção ao efeito da dopamina, hormônio da euforia, e à memória das intensas sensações de prazer promovidas pela droga. A satisfação proporcionada pela droga, entretanto, é a única alternativa ao gozo fálico, aquele que se satisfaz no exercício da fala e que tem lugar dentro do laço social.(AU)
The author emphasizes two conceptions of memory in the Freudian theories, before and after 1920, and discusses their relationships to pleasure, satisfaction and wish, relationships that are characteristic of the primary psychic processes, which seek the identity of perception. Taking drug dependency as a paradigm of addictions, a problem especially present in contemporariness, the author shows that neuroscience links addiction to dopamine, the hormone of euphoria, and to the memory of the intense pleasure sensations promoted by the drug. The satisfaction promoted by the drug, however, is the only alternative to the phallic jouissance, which is the one that is satisfied in the exercise of speech and that happens inside the social bond.(AU)