A Double-blind, Placebo-controlled, Randomized Comparison of Analgesic Efficacy of Oral Ketorolac Versus Intramuscular Tramadol After Third Molar Surgery

Background: Pain due to dental extraction, particularly after the third molar extraction causes discomfort to patients. Different types of analgesics used to manage pain in such cases include nonsteroidal anti-inflammatory drugs and opioids. Objectives: To evaluate the pre-emptive analgesic effectiveness of oral ketorolac and intramuscular (IM) tramadol following lower third molar surgeries. Materials and Methods: A total 60 subjects with impacted mandibular third molars were included in our study. They were randomized into two treatment groups, each with 30 patients. Group A: oral ketorolac 10 mg and IM placebo (1 mL saline solution); Group B: oral placebo (tablet similar to oral ketorolac) and IM tramadol 50 mg diluted in 1 mL saline solution. The treatment regimen were given half an hour before the start the surgery. The parameters evaluated were pain intensity, the time of first analgesic rescue medication and total analgesic consumption. Results: We found that the time of first rescue analgesic medication was longer in oral ketorolac group than IM tramadol group (P=0.01). Group A patients experienced less pain than Group B patients. Conclusion: We found that oral ketorolac group of patients had an enhanced analgesic effectiveness and a longer time of first rescue analgesic than those taking intramuscular tramadol.