title: Attenuation of C-reactive protein increases after exodontia by tramadol and ibuprofen.
abstract: The anti-inflammatory effects of ibuprofen and tramadol were investigated by measuring C-reactive protein concentrations after removal of an impacted lower third molar. Forty-five American Society of Anesthesiologists Class I patients were randomly categorized into 3 equal groups according to postoperative analgesic medication. The first group received tramadol (100 mg every 8 hours), the second group received ibuprofen (400 mg every 8 hours), and the last group received half doses of both drugs in combination (50 mg tramadol every 8 hours and 200 mg ibuprofen every 8 hours). C-reactive protein was measured before surgery to exclude the presence of any preexisting inflammatory condition that might interfere with the study. C-reactive protein was also determined immediately after surgery and 72 hours postoperatively. At 72 hours, C-reactive protein had increased over postsurgery baseline by 123% in the tramadol group (P < .001), 84% in the ibuprofen group (P < .001), and only 37% in the combined analgesic group (P = .078). These results suggest that tramadol may produce supra-additive anti-inflammatory effects with ibuprofen after third-molar extractions.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tanta University, Cairo, Egypt. elsharrawy@hotmail.com
authors.forename: Eman A
authors.initials: EA
authors.lastname: El-Sharrawy
authors.forename: Ibrahim E
authors.initials: IE
authors.lastname: El-Hakim
authors.forename: Elham
authors.initials: E
authors.lastname: Sameeh
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology* / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000494:pharmacology* / Q000627:therapeutic use; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control*; D008297:Male; D008334:Mandible; D008964:Molar, Third / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control; D018709:Statistics, Nonparametric; D014081:Tooth Extraction; D014147:Tramadol / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D014147:Tramadol; D002097:C-Reactive Protein; D007052:Ibuprofen