Postoperative Analgesia for Third Molar Surgery

A study by AM Tuzuner Oncul et al compared the postoperative analgesic effects of preoperative intravenous paracetamol, diclofenac sodium, and lornoxicam (nonsteroidal anti-inflammatory drugs) for patients undergoing surgical removal of impacted third molars. The study involved 60 patients with impacted third molars who were randomly allocated into 3 groups of 20 patients each. Preoperatively, group P received 1 g paracetamol intravenous; group D received a 75-mg diclofenac sodium intramuscular injection; and group L received 8 mg lornoxicam intravenous. Postoperative pain intensity, additional consumption of analgesics postoperatively, and postoperative complications were compared among groups. The study found that all groups were comparable for pain scores (P > .05). Maximum pain scores were recorded in the fourth hour postoperatively in all groups (group L 22, 14 to 44 mm; group P 24, 13 to 43 mm; group D 14, 10 to 24 mm, P = .117). Patients experienced high satisfaction scores, which were comparable among the groups (group L 85, 75 to 100 mm; group P 87, 70 to 95 mm; group D 84, 77 to 98 mm, P = .457). The authors conclude that preoperative intramuscular diclofenac sodium, paracetamol intravenous, and lornoxicam intravenous effectively decreased the pain scores. The patients were satisfied with the 3 postoperative pain management regimens.
(Source: Medical Principles and Practice, International Journal of the Kuwait University Health Sciences Centre. July 2011, Volume 20, Number 5, page 470)