The impact of ketorolac and paracetamol on post-operative pain and analgesic consumption post-dental extraction

Abstract

Background: Despite being very popular, there is limited direct comparative research that has evaluated their efficacy in post-extraction pain control between ketorolac and paracetamol. Those undertaken have shown varied results; some show that ketorolac is superior in pain relief and duration of action and others show no significant difference in efficacy between the two. This discrepancy underlines the need for further research that is important in determining the relative efficacy of the two analgesics in those patients undergoing dental extractions, something that is very important in guiding the choice of analgesic for the clinician to use in the emergency room for dental patients. Aims and Objectives: This study aimed to compare the analgesic efficacy of paracetamol (500 mg) and ketorolac (10 mg) in managing acute pain following dental extractions. Materials and Methods: A prospective, randomized, and double-blind controlled trial was conducted on 80 patients undergoing single tooth extraction. Participants were allocated to receive either paracetamol 500 mg or ketorolac 10 mg orally post-extraction. Pain intensity was assessed using the visual analog scale at predetermined intervals post-extraction. Secondary outcomes included time to first analgesic request besides total analgesic consumption over 24 h. Results: Patients from Group II (ketorolac) demonstrated lower intensity pain scores at all-time points post-extraction compared to Group I (paracetamol). On the other hand, Group-I (ketorolac) demonstrated an extended time to the first analgesic request (P = 0.914) and lower total analgesic consumption (P = 0.0001) in the first 24-h post-extraction than Group-I (paracetamol). Conclusion: Ketorolac (10 mg) functioned better for pain than paracetamol (500 mg) in reducing pain intensity following dental extractions, with a longer duration of analgesic effect and reduced need for additional analgesia. These findings suggest that ketorolac may be preferred over paracetamol for immediate post-operative pain management within dental extractions, considering patient-specific contraindications and risk factors.