title: Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery.
abstract: BACKGROUND
  The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial inflammatory and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered dexamethasone and diclofenac potassium (diclofenac K) with diclofenac K alone on the postoperative pain, swelling and trismus after surgical removal of third molars.
  
  
  METHODS
  A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria. A total of 100 patients were randomly allocated to two treatment groups of dexamethasone (prophylactic 8 mg and postoperative 4 mg IV) and diclofenac K (50 mg Oral before and after surgery), and diclofenac K alone (as with first group). The overall analgesic efficacy of the drug combinations was assessed postoperatively by determination of pain intensity using a category rating scale. Facial swelling was measured using a tape measure placed from tragus to gonion to tragus, while interincisal mouth-opening of patients was measured using a vernier calibrated caliper pre-operatively and post-operatively.
  
  
  RESULTS
  Co-administration of dexamethasone and diclofenac K was significantly superior to diclofenac alone for the relief of pain (P < 0.05), and facial swelling up to post-operative 48 hour (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05).
  
  
  CONCLUSIONS
  This study illustrates enhanced effects of co-administered dexamethasone and diclofenac K on short-term post-operative pain and swelling, compared to diclofenac potassium alone in third molar surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, P,M,B 12003, Lagos, Nigeria. tuntop@yahoo.com
authors.forename: Babatunde Olamide
authors.initials: BO
authors.lastname: Bamgbose
authors.forename: Jelili Adisa
authors.initials: JA
authors.lastname: Akinwande
authors.forename: Wasiu Lanre
authors.initials: WL
authors.lastname: Adeyemo
authors.forename: Akinola Ladipo
authors.initials: AL
authors.lastname: Ladeinde
authors.forename: Godwin Toyin
authors.initials: GT
authors.lastname: Arotiba
authors.forename: Mobolanle Olugbemiga
authors.initials: MO
authors.lastname: Ogunlewe
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome; D014313:Trismus / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D004008:Diclofenac; D003907:Dexamethasone