Effect of Preemptive Amitriptyline on Postoperative Pain after Impacted Mandibular Third Molar Extraction: A...

Objectives: Extraction of impacted mandibular third molars is one of the most common procedures in oral and maxillofacial surgery, which is usually associated with significant postoperative pain. This study aimed to evaluate the effect of preemptive amitriptyline on postoperative pain after impacted mandibular third molar extraction. Materials and Methods: This randomized double-blind placebo-controlled clinical trial included 20 patients (n=40 teeth) who referred to the Department of Oral and Maxillofacial Surgery of Tabriz Dental School for bilateral extraction of impacted third molars. After obtaining ethical approval and informed consent, the participants were randomly assigned to two groups: the intervention group received 25 mg amitriptyline preemptively while the control group received a placebo. The primary outcomes included postoperative pain score measured by a visual analog scale (VAS), and the frequency of analgesics taken during the postoperative period. Data were analyzed by paired samples t-test (alpha=0.05). Results: A total of 20 patients (10 males and 10 females) participated in this study, with a mean age of 22.2 years. The mean duration of surgery was almost similar in the two groups (P=0.847). The intervention group consumed significantly lower number of analgesics during the postoperative period than the control group (P<0.001). The time interval from surgery to the first analgesic intake was significantly longer in the amitriptyline group (P<0.001). Conclusion: Preemptive consumption of amitriptyline can effectively reduce postoperative pain and analgesic consumption following impacted mandibular third molar extraction surgery.