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Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial.
Med Oral Patol Oral Cir Bucal. 2019 Jan 01; 24(1):e96-e102.MO

Abstract

BACKGROUND

This study compared the efficacy of ketorolac alone versus its combination with tramadol/acetaminophen for pain control after mandibular third molar surgery.

MATERIAL AND METHODS

A randomized, triple-blind clinical trial was carried out with 52 patients divided into 2 groups: Group K+T+A (1 tablet of Ketorolac 10 mg plus and 1 capsule of Tramadol 37.5 mg/acetaminophen 325 mg) and Group K (1 tablet of Ketorolac 10 mg plus and 1 placebo capsule). The treatments were given 1 h before the surgery and was repeated 4 times per day, for 48 h. The difference in postoperative pain was assessed by 4 primary end-points: pain intensity (VAS 100mm, for 48 h), rescue medication, overall assessment and adverse effects.

RESULTS

Significant differences in pain intensity were observed in the different times (p < 0.05). The comparison of groups in each time showed significant differences only of 9 h, with lower level of pain intensity for group K+T+A (p = 0.005). The need of analgesics was higher in Group K (p < 0.001), the need of antiemetic were greater in Group K+T+A (p < 0.0001). No significant difference between groups were observed in overall assessment. The adverse effects was higher in Group K+T+A.

CONCLUSIONS

The current study showed that both ketorolac and the combination of ketorolac plus tramadol/acetaminophen showed good control of pain after the extraction of the lower third molars. Although the combination group showed lower pain at 9 h, the difference is small and not clinically relevant.

Authors+Show Affiliations

Rua Carlos Cavalcanti, 4748 Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, Brazil 84030-900, dorochenkoluciana@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30573715

Citation

Martins, L-D, et al. "Analgesic Efficacy of Ketorolac Associated With a Tramadol/acetaminophen Combination After Third Molar Surgery - a Randomized, Triple-blind Clinical Trial." Medicina Oral, Patologia Oral Y Cirugia Bucal, vol. 24, no. 1, 2019, pp. e96-e102.
Martins LD, Rezende M, Loguercio AD, et al. Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial. Med Oral Patol Oral Cir Bucal. 2019;24(1):e96-e102.
Martins, L. D., Rezende, M., Loguercio, A. D., Bortoluzzi, M. C., & Reis, A. (2019). Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial. Medicina Oral, Patologia Oral Y Cirugia Bucal, 24(1), e96-e102. https://doi.org/10.4317/medoral.22744
Martins LD, et al. Analgesic Efficacy of Ketorolac Associated With a Tramadol/acetaminophen Combination After Third Molar Surgery - a Randomized, Triple-blind Clinical Trial. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e96-e102. PubMed PMID: 30573715.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial. AU - Martins,L-D, AU - Rezende,M, AU - Loguercio,A-D, AU - Bortoluzzi,M-C, AU - Reis,A, Y1 - 2019/01/01/ PY - 2018/09/02/received PY - 2018/11/02/accepted PY - 2018/12/24/pubmed PY - 2019/8/2/medline PY - 2018/12/22/entrez SP - e96 EP - e102 JF - Medicina oral, patologia oral y cirugia bucal JO - Med Oral Patol Oral Cir Bucal VL - 24 IS - 1 N2 - BACKGROUND: This study compared the efficacy of ketorolac alone versus its combination with tramadol/acetaminophen for pain control after mandibular third molar surgery. MATERIAL AND METHODS: A randomized, triple-blind clinical trial was carried out with 52 patients divided into 2 groups: Group K+T+A (1 tablet of Ketorolac 10 mg plus and 1 capsule of Tramadol 37.5 mg/acetaminophen 325 mg) and Group K (1 tablet of Ketorolac 10 mg plus and 1 placebo capsule). The treatments were given 1 h before the surgery and was repeated 4 times per day, for 48 h. The difference in postoperative pain was assessed by 4 primary end-points: pain intensity (VAS 100mm, for 48 h), rescue medication, overall assessment and adverse effects. RESULTS: Significant differences in pain intensity were observed in the different times (p < 0.05). The comparison of groups in each time showed significant differences only of 9 h, with lower level of pain intensity for group K+T+A (p = 0.005). The need of analgesics was higher in Group K (p < 0.001), the need of antiemetic were greater in Group K+T+A (p < 0.0001). No significant difference between groups were observed in overall assessment. The adverse effects was higher in Group K+T+A. CONCLUSIONS: The current study showed that both ketorolac and the combination of ketorolac plus tramadol/acetaminophen showed good control of pain after the extraction of the lower third molars. Although the combination group showed lower pain at 9 h, the difference is small and not clinically relevant. SN - 1698-6946 UR - https://www.unboundmedicine.com/medline/citation/30573715/Analgesic_efficacy_of_ketorolac_associated_with_a_tramadol/acetaminophen_combination_after_third_molar_surgery___a_randomized_triple_blind_clinical_trial_ L2 - http://www.medicinaoral.com/medoralfree01/aop/22744.pdf DB - PRIME DP - Unbound Medicine ER -