A comparative clinical evaluation of analgesic efficacy of Tapentadol and ketorolac in mandibular third molar surgery

Abstract

Introduction: The surgical removal of impacted mandibular third molars is one of the most commonly performed dentoalveolar procedures in oral and maxillofacial surgery and is associated with varying degrees of postoperative discomfort. Pain, trismus, and swelling are the most common postoperative complaints, and these influence a patient's quality of life in the days after surgery.

Materials and methods: A comparative study of the 32 patients, 16 were allocated to receive ketorolac and 16 patients were allocated to receive tapentadol. As the data for this study were collected at different time points, analysis for the longitudinal study was done. The main outcome variable, pain level was measured in five-ordered categories. As we had ordinal data in our study, we first checked for marginal homogeneity through Cochran-Mantel-Haenszel test.

Results: In the present study, the results show that there is no statistically significant difference between the two treatment groups (P = 0.1184). According to results, there is no significant group by time interaction, which means both drugs have shown almost equal efficacy at different time points. Similarly, there is no difference in efficacy of the two drugs across gender level.

Conclusion: The present findings showed that there is no statistically significant difference between the two treatment groups, although ketorolac is more effective for immediate pain reduction than tapentadol. However, the overall reduction of pain using both groups has no significant difference.

Keywords: Impaction; nonsteroidal anti-inflammatory drugs; opioid analgesics; third molar.

Figure 1

One hour after surgery

Figure 2

Four hours after surgery

Figure 3

Ten hours after surgery

Figure 4

First postoperative day

Figure 5

Second postoperative day

Figure 6

Third postoperative day