Preoperative Intravenous Tramadol Versus Diclofenac for Preventing Postoperative Pain After Third Molar Surgery: A Comparative Study

Abstract

The purpose of this study was to compare the analgesic efficacy of a single-dose of preoperative intravenous tramadol versus diclofenac in preventing pain after third molar surgery. Fifty patients undergoing elective third molar surgery were randomly assigned into one of the two groups (25 in each group): Group 1 received diclofenac 75mg, and Group 2 received tramadol 50mg intravenously preoperatively before the surgery. After injection of the study drugs, the impacted third molars were removed under local anesthetic agent. The difference in postoperative pain was assessed by four primary end-points: pain intensity as measured by a 100mm visual analogue scale hourly for 12h, median time to rescue analgesic, postoperative acetaminophen consumption, and patient's global assessment. Throughout the 12h investigation period, patients reported significantly lower pain intensity scores in the diclofenac versus tramadol group (P=0.0001, Mann-Whitney U-test). Patients also reported significantly longer median time to rescue analgesic (10 vs. 8h, P<0.05, Student t test), lesser postoperative acetaminophen consumption (P<0.05, Student t test) for the diclofenac versus tramadol group. Preoperative intravenous diclofenac 75mg is more effective than tramadol 50mg in the prevention of postoperative dental pain.