Tramadol versus ketorolac for pain management after third molar surgery

To compare the analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery.

Two hundred patients in the age group of 18-40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups (100 in each group) and underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary end points: pain intensity being measured hourly by Wong-Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient's global assessment.

Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug-related complications were mild and did not require any investigation.

The result of the present study shows that preoperative IV ketorolac 30 mg is more effective than tramadol 50 mg for postoperative pain following third molar surgery.