Abstract
This systematic review and meta-analysis evaluated if ketorolac reduces the intensity of postoperative pain after impacted third molars surgery in adults compared to the use of tramadol. A comprehensive search was performed in the MEDLINE/PubMed, Scopus, Web of Science, LILACS, BBO, EMBASE, Cochrane Library, SIGLE and grey literature, in accordance with the PRISMA guidelines. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. After duplicates removal, 4526 articles were identified, but only nine studies were included for qualitative analysis. After updating in 2021, four studies were added, totaling 13 studies included for qualitative analysis. Only two studies, classified at “low” risk of bias, were included in the meta-analysis of the primary outcome. The difference in means for pain intensity (moderate quality of evidence due to imprecision) was – 0.27 (95% CI = – 0.82 to 0.28; p = 0.34). Data from adverse effects (low quality of evidence due to very serious issues in imprecision) was just reported in one study at “low” risk of bias. Data was not heterogeneous (Chi2 test p = 0.14; I2 = 55%). It was not possible to evaluate any secondary outcomes (time to first rescue analgesic drug in h, total amount of analgesics consumed and adverse effects) due to low number of studies included. There is a lack of strong evidence to assure the superiority of ketorolac or tramadol in reducing the postoperative pain after extraction of impacted third molars.
Highlights
A Pain is a major postoperative symptom after many dental procedures, extraction of impacted third molars, which is the most frequent surgical intervention in dentistry (Isiordia-Espinoza, de Jesús Pozos-Guillén, & Aragon-Martinez, 2014)
For each one of the concepts medical subheadings (MESH) and free keyword were combined with the Boolean operator “OR” and the two concepts combined with the Boolean operator “AND”
The reasons for exclusion were (1) two studies evaluated postoperative pain after maxillofacial surgery (Shankariah, Mishra, & Kamath, 2012; Zackova, Taddei, Calò, Bellocchio, & Zanello, 2001) and (2) one study combined both drugs for treatment (Isiordia-Espinoza et al, 2011)
Summary
A Pain is a major postoperative symptom after many dental procedures, extraction of impacted third molars, which is the most frequent surgical intervention in dentistry The intensity of the pain after extraction of third molars is usually moderate to severe. Pain occurs within the first 24 h after surgery, peaking between 6 h and 8 h when conventional anesthesia is performed Martínez-Rider, Herrera-Abarca, & Pérez-Urizar, 2011; Seymour, Meechan, & Blair, 1985). 1999), leading to an undesirable risk of pain. This situation can be managed with preemptive analgesia (Isiordia-Espinoza et al, 2011; Ong & Seymour, 2003) 2008; Moraschini, Hidalgo, & Porto Barboza, 2016), as well as the release of chemical mediators (prostaglandins, leukotrienes, bradykinin, serotonin and histamine) (Dray, 1997), activates and sensitizes nerve fiber receptors
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
