The Effectiveness of Ketorolac in Relieving Pain Associated With Root Canal Therapy: A Systematic Review and...

Effective management of post-endodontic pain is crucial for patient comfort. Although ketorolac is used for this purpose, its efficacy relative to other analgesics remains uncertain. This study systematically assesses evidence from randomized clinical trials that investigate the comparative effectiveness of ketorolac and other analgesic agents for the control of post-endodontic pain.

This study conducted a comprehensive search across several databases, including PubMed, Web of Science, ScienceDirect, Cochrane Library, Embase, Scopus, SinoMed, CNKI, Webvpn, and Wanfang Data. Search deadline was around August 2025. The study employed the inverse variance approach and a random effects model to analyze continuous data, utilizing the standardized mean as the comprehensive effect indicator. For dichotomous data, this study applied the risk ratio (RR), fixed-effect analysis model, and Mantel-Haenszel statistical methods.

Our database search identified 386 potentially relevant studies. Ultimately, seven studies were selected for qualitative analysis, and five were chosen for quantitative analysis. The qualitative assessment indicated that five studies favored ketorolac, one study reported similar analgesic effects between ketorolac and alternative medications, while one study concluded that ketorolac was less effective. The quantitative analysis demonstrated a statistically significant difference in the analgesic effect of ketorolac compared to other drugs at 6 h post-administration. However, the analgesic effects of ketorolac did not show statistically significant differences compared to other medications at 12 or 24 h post-administration. Additionally, a lower proportion of patients required supplementary drug treatment after receiving ketorolac compared to those treated with other analgesics.

This meta-analysis concluded that ketorolac is effective for managing post-endodontic pain within the first 6 h and reduces the need for rescue medication compared to alternatives, thereby supporting its use as a favorable option following root canal treatment.