Comparative study of tramadol combined with dexamethasone and diclofenac sodium in third-molar surgery.
The aim of this randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia with a combination of tramadol+dexamethasone or tramadol+diclofenac sodium. The study included 30 patients (age range: 16-30 years), who were randomly assigned to 2 groups by the split-mouth method. Postoperative pain was assessed with a visual analogue scale at 4, 6, 12, 24, and 48 h postoperatively (p.o.h.). Swelling was measured at 48 p.o.h. Maximal interincisor distance was measured at 48 p.o.h. and 7 postoperative days (p.o.d.). Significant differences in postoperative pain intensity were detected between the drug combinations at 4, 6, and 12p.o.h., suggesting the importance of preemptive analgesia. Patients treated with tramadol+dexamethasone showed lower pain scores compared to the tramadol+diclofenac sodium combination, larger postoperative mouth opening, and less swelling. The tramadol+dexamethasone combination also was more effective than tramadol+diclofenac sodium at reducing inflammation.
Center for Postgraduate Program in Medicine, Federal University of Sergipe (UFS), Brazil. jadsonalipio@hotmail.com
Jadson Alípio Santana
JA
de Sousa Santos
Luiz Carlos Ferreira
LC
da Silva
Thiago
T
de Santana Santos
Laerte Ribeiro
LR
Menezes Júnior
Ana Carla
AC
de Assunção Oliveira
José Renato Moraes Carvalho Barreto
JR
Brandão
D000082:Acetaminophen / Q000008:administration & dosage; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D004487:Edema / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011292:Premedication; D016059:Range of Motion, Articular / Q000187:drug effects; D014081:Tooth Extraction / Q000379:methods; D014095:Tooth, Impacted / Q000601:surgery; D014147:Tramadol / Q000008:administration & dosage*; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D004008:Diclofenac; D000082:Acetaminophen; D014147:Tramadol; D003907:Dexamethasone