title: Analgesic and adjuvant anesthetic effect of submucosal tramadol after mandibular third molar surgery.
abstract: OBJECTIVE
  The aim of this study was to assess analgesic and adjuvant anesthetic effects of submucosal tramadol after third molar extraction.
  
  
  METHODS
  In this double-blind, split-mouth, placebo-controlled, single-dose, crossover investigation, 52 patients underwent mandibular third molar extraction under local anesthesia. Surgical side was randomly assigned to submucosal 2 mL 100 mg tramadol injection (group T) or normal saline solution (group P) immediately after surgery. Anesthetic blockade duration, time of intake and amount of analgesic rescue drug, and postoperative pain intensity were recorded immediately after anesthesia cessation and 4, 8, 24, 48, and 72 hours after surgery. Data were submitted to analysis of variance and Wilcoxon tests.
  
  
  RESULTS
  Anesthetic blockade duration between groups was similar. Group T took significantly less rescue drug after 72 hours (P = .008). Time elapsed before first intake of rescue drug was longer (P = .006), and pain intensity was significantly lower (P = .001) in group T.
  
  
  CONCLUSIONS
  Submucosal tramadol injection after oral surgery improved postoperative analgesia, but did not extend anesthetic action duration.
authors.affiliation: Oral and Maxillofacial Surgery Department, General Clinics Hospital School of Medicine, University of Sao Paulo, São Paulo, Brazil.
authors.forename: Marcelo Minharro
authors.initials: MM
authors.lastname: Ceccheti
authors.affiliation: Oral and Maxillofacial Surgery Department, General Clinics Hospital School of Medicine, University of Sao Paulo, São Paulo, Brazil.
authors.forename: Giovana Vigário
authors.initials: GV
authors.lastname: Negrato
authors.affiliation: Dentistry Division, General Clinics Hospital, School of Medicine, University of Sao Paulo, São Paulo, Brazil.
authors.forename: Maria Paula Siqueira de Melo
authors.initials: MP
authors.lastname: Peres
authors.affiliation: Oral and Maxillofacial Surgery Department, School of Dentistry, University of Sao Paulo, São Paulo, Brazil. Electronic address: mczdebon@usp.br.
authors.forename: Maria Cristina Zindel
authors.initials: MC
authors.lastname: Deboni
authors.affiliation: Oral and Maxillofacial Surgery Department, School of Dentistry, University of Sao Paulo, São Paulo, Brazil.
authors.forename: Maria da Graça
authors.initials: Mda G
authors.lastname: Naclério-Homem
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000772:Anesthesia, Local / Q000379:methods; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008334:Mandible / Q000601:surgery; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D010919:Placebos; D011446:Prospective Studies; D014081:Tooth Extraction; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D010919:Placebos; D014147:Tramadol