Comparison of the analgesic efficacy of oral ketorolac versus intramuscular tramadol after third molar surgery: A parallel, double-blind, randomized, placebo-controlled clinical trial

Abstract

Background: Preemptive analgesia is considered an alternative for treating the postsurgical pain of third molar removal. The aim of this study was to evaluate the preemptive analgesic efficacy of oral ketorolac versus intramuscular tramadol after a mandibular third molar surgery.

Material and methods: A parallel, double-blind, randomized, placebo-controlled clinical trial was carried out. Thirty patients were randomized into two treatment groups using a series of random numbers: Group A, oral ketorolac 10 mg plus intramuscular placebo (1 mL saline solution); or Group B, oral placebo (similar tablet to oral ketorolac) plus intramuscular tramadol 50 mg diluted in 1 mL saline solution. These treatments were given 30 min before the surgery. We evaluated the time of first analgesic rescue medication, pain intensity, total analgesic consumption and adverse effects.

Results: Patients taking oral ketorolac had longer time of analgesic covering and less postoperative pain when compared with patients receiving intramuscular tramadol.

Conclusions: According to the VAS and UAC results, this study suggests that 10 mg of oral ketorolac had superior analgesic effect than 50 mg of tramadol when administered before a mandibular third molar surgery.

Figure 1

Clinical trial flowchart of a subject´s progress through the phases of the study.

Figure 2

Pain intensity evaluated by AUC of VAS. Group A, oral ketorolac 10 mg plus intramuscular placebo; Group B, oral placebo plus intramuscular tramadol 50 mg (P=0.043).

Figure 3

Overall evaluation of analgesic treatments. Group A, oral ketorolac 10 mg plus intramuscular placebo; Group B, oral placebo plus intramuscular tramadol 50 mg (P=0.027).