A clinical study on the analgesic efficacy of ketorolac tromethamine compared with diclofenac sodium after impacted mandibular third-molar surgical extraction. (randomised controlled trial).

Abstract

Background and Aim of study: the surgical removal of impacted mandibular third-molar is considered the most popular procedure in oral surgery, and the postoperative pain is the first cause of discomfort in most patients. This single-blind, split-mouth and randomized study was aimed to compare the analgesic efficacy of the non-steroidal antiinflammatory drugs( ketorolac tromethamine and diclofenac sodium) after impacted mandibular third-molar surgical extraction.

Materials and Methods: thirty-four individuals aged 18-40 years, having bilateral mandibular third molars, in a similar position, were selected. Tow different surgical procedures were performed on the same individual by the single surgeon. For test side, the individual received 30mg of ketorolac injected into the gluteal muscle immediately after suturing of the surgical wound, followed by 10mg ketorolac tablet orally every 8 hours for 5 days after surgery. For control side, the individual received 75mg of diclofenac injected into the gluteal muscle immediately after suturing of the surgical wound, followed by 50mg diclofenac tablet orally every 8 hours for 5 days after surgery. The visual analogue scale-11 points-was used to assess pain at 6 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours postoperatively.

Results: data was analyzed using spss v.25(IBM, USA), and statistically evaluated with Mann-Whitney U test to compare the values between the the tow groups(test and control) during the follow-up periods. The level of significance was set at 0,05. Test group had statistically significant effect in reduction of pain compared with control group(p< 0,05) at all the follow-up periods.

Conclusions: ketorolac showed better analgesic effect than diclofenac for post-operative pain management. The results of this study suggest that ketorolac tromethamine could be an interesting alternative to conventional choice(diclofenac sodium) for use after routine surgical extractions of impacted mandibular third-molars.