Comparative study of analgesic effectiveness of tramadol and ketorolac in the pain management of surgical removal of third molar: a randomized double blinded study

Abstract

AIM: Assessing the efficacy of drug in controlling pain intensity after surgical removal of impacted mandibular third molar teeth and to compare the effects. MATERIAL AND METHODS: A double-blind, randomized, controlled clinical trial was conducted. 40 patients were randomly selected and divided into two equal groups. Group A received 50 mg of tramadol orally and Group B received 10 mg of ketorolac orally. In both groups dose was repeated for next 24 hrs. Visual analogue scale was used for the collection of pain intensity from the patients. RESULTS: The results revealed, in Group A, the analgesia started within 1 hour and reached the maximum analgesic effect in 4 hours, pain intensity was 1.8 out of 10, on visual analog scale. In Group B, analgesia started within 1hour and showed it’s maximum analgesic effect. The pain intensity was 2.5 on visual analog scale. The analgesic effect of 50 mg tramadol lasted up to 6 hours and that of ketorolac lasted for 5 hour. CONCLUSION: The study shows that 50mg tramadol is a suitable and safe analgesic for the relief of post-extraction pain and is more effective than 10mg ketorolac with prolonged analgesia and minimal side effects, we recommend studies with randomized clinical trials with larger sample size are needed it in clinical practice.

Does Ketorolac reduce the intensity of postoperative pain after impacted third molars surgery in adults compared to the use of tramadol? A systematic review and meta-analysis

“…Some studies did not contain all the information needed; thus, emails were sent to seven authors to request further information (Chethan et al, 2015;Dayashankara Rao, 2010;Gopalraju et al, 2014;Isiordia-Espinoza et al, 2016;Shah et al, 2013;, and five of them did not answer (Chethan et al, 2015;Dayashankara Rao, 2010;Gopalraju et al, 2014;Isiordia-Espinoza et al, 2016;.…”

“…The characteristics of the thirteen included studies are listed in Tables 2 and 3. The parallel study design prevailed (Chethan et al, 2015;Dayashankara Rao, 2010;Gopalraju et al, 2014;Isiordia-Espinoza et al, 2016;Mangalgi, Shah, Sajjanshetty, Patil, & Halkai, 2018;Mishra & Khan, 2012;Nasyam, 2020;Ong & Tan, 2004;Passi et al, 2018;Pathi, Vidya, & Sangamesh, 2020; except in one study that used the crossover design (Shah et al, 2013).…”

“…The majority of them were carried out in a university environment, except three, which were conducted in a partnership between a hospital and university (Dayashankara Rao et al, 2010;Shah et al, 2013;. In six out of the thirteen studies, the drug was only administered preoperatively (Gopalraju et al, 2014;Isiordia-Espinoza et al, 2016;Nasyam, 2020;Ong & Tan, 2004;Pathi et al, 2020;Shah et al, 2013), in four studies the drug was only administered postoperatively (Chethan et al, 2015;Dayashankara Rao, 2010;Mangalgi et al, 2018;Passi et al, 2018) and in three studies the drug was administered perioperatively (Mishra & Khan, 2012;.…”

“…Regarding the route of administration, six studies used the oral route (R. Chethan et al, 2015;Dayashankara Rao et al, 2010;Mishra & Khan, 2012;Passi et al, 2018;, two study employed the intramuscular route (Mangalgi et al, 2018;Shah et al, 2013), three used the intravenous route (Gopalraju et al, 2014;Ong & Tan, 2004;Pathi et al, 2020) and two study combined the oral and intramuscular routes (Isiordia-Espinoza et al, 2016;Nasyam, 2020).…”

“…A large number of randomized clinical trials compared the analgesic efficacy of ketorolac and tramadol after thirdmolar surgery (Chethan, Ramamuthy, Patil, & Reddy, 2015;Dayashankara Rao et al, 2010;Gopalraju, Lalitha, Prasad, & Ranganath, 2014;Isiordia-Espinoza et al, 2016;Mishra & Khan, 2012;Ong & Tan, 2004;Shah, Arun Kumar, Rai, & Rajesh Kumar, 2013;. There are studies that reported the superiority of ketorolac in controlling postoperative pain (Gopalraju et al, 2014;Isiordia-Espinoza et al, 2016;Ong & Tan, 2004;Shah et al, 2013), while others showed that tramadol performed better (Chethan et al, 2015;Dayashankara Rao et al, 2010;; another study described no differences between them (Mishra & Khan, 2012).…”