Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial

• Luciana-Dorochenko Martins ^[1] ; Márcia Rezende ^[2] ; Alessandro D. Loguercio ^[1] ; Marcelo-Carlos Bortoluzzi ^[1] ; Alessandra Reis ^[1]
  1. [1] Universidade Estadual de Ponta Grossa

     Universidade Estadual de Ponta Grossa

     Brasil

     
  2. [2] DDS, MS, PhD, Professor School of Dentistry. Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 24, Nº. 1 (January ), 2019
• Idioma: inglés
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• Resumen

  • This study compared the efficacy of ketorolac alone versus its combination with tramadol/acetaminophen for pain control after mandibular third molar surgery.

    A randomized, triple-blind clinical trial was carried out with 52 patients divided into 2 groups: Group K+T+A (1 tablet of Ketorolac 10 mg plus and 1 capsule of Tramadol 37.5 mg/acetaminophen 325 mg) and Group K (1 tablet of Ketorolac 10 mg plus and 1 placebo capsule). The treatments were given 1 h before the surgery and was repeated 4 times per day, for 48 h. The difference in postoperative pain was assessed by 4 primary end-points: pain intensity (VAS 100mm, for 48 h), rescue medication, overall assessment and adverse effects.

    Significant differences in pain intensity were observed in the different times (p<0.05). The comparison of groups in each time showed significant differences only of 9 h, with lower level of pain intensity for group K+T+A (p = 0.005). The need of analgesics was higher in Group K (p<0.001), the need of antiemetic were greater in Group K+T+A (p<0.0001). No significant difference between groups were observed in overall assessment. The adverse effects was higher in Group K+T+A.

    The current study showed that both ketorolac and the combination of ketorolac plus tramadol/acetaminophen showed good control of pain after the extraction of the lower third molars. Although the combination group showed lower pain at 9 h, the difference is small and not clinically relevant.