Comparative Evaluation of Analgesic Efficacy of Oral Ketorolac and Tramadol after Impacted Mandibular Third Molar Surgery: A Short Clinical Study with Literature Review

Author(s): Deepak Passi*, Mahinder Singh, Abhishek Singh, Shubharanjan Dutta, Jyoti Goyal, Garima Yadav, Neha Singh and Dhirendra Srivastava

Aim & objectives: The aim of this study was to evaluate the analgesic efficacy of oral ketorolac versus tramadol after a mandibular third molar surgery. Material and Methods: Total of 100 healthy patients under the age group of 20-60 years requiring surgical extraction of a impacted mandibular third molar were divided randomly into 2 groups of 50 each Group A (Ketorolac) & Group B (Tramadol) and received 10 mg of ketorolac thrice and 50 mg Tramadol twice a day respectively. Pain intensity was recorded after 30 minutes; 1st hrs, 4th hrs, 6th hrs, 12th hrs & 24 hrs after surgical procedure using the visual analog scale. Results: Mean age was 31± 8.1 years in Group A and 33 ± 10.4 in Group B. Group A included 34 males (68%), 16 females (32%) whereas Group B included 30 males (60%), 20 females (40%). Average weight of patients in Group A was 58.8 kg and in Group B was 61.4 kg. 75% Study includes Mesioangular (75%), 15% Horizontal (15%) and 10% Distoangular (10%) type of impacted teeth. Mean difficulty index for group A was 7.4 and for group B was 7.8 (Pederson Scale). Mean duration of surgery in Group A was 45 ± 6 minutes and in Group B was 48 ± 8 minutes. Acute pain relief was observed in Ketorolac group with in half hour (min VAS was 2.68) but for shorter duration of 4-5 hrs. However depth (min VAS score 1.65) and duration of analgesia (8-10 hrs) was more in tramadol group. Complications like nausea/vomiting (8%) and drowsiness/sedation (6%) was observed more in tramadol group whereas upper gastric pain/acidity (8%) was more in Ketorolac group. Conclusion: Oralketorolac is a good analgesic drug (NSAID) for acute pain of inflammatory etiology like surgical extraction of impacted teeth.

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