Premedication with diclofenac and prednisolone to prevent postoperative pain and swelling after third molar removal

Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid are able to effectively reduce the postoperative sequelae after impacted third molar removal. However, few studies have evaluated the activity of the combined effects of these two drugs. The purpose of this study was to evaluate whether a single dose of prednisolone, taken orally before operation, would increase the effects of diclofenac in preventing pain and swelling after surgical removal of impacted third molars.

Thirty healthy patients requiring surgical removal of four third molars were randomly assigned to two groups. In group A, patients were preoperatively given 50 mg of either diclofenac or placebo when impacted teeth were removed on each side. In group B, in addition to 50 mg of diclofenac, 10 mg of prednisolone or placebo was administered. Postoperative pain, swelling and range of mouth opening were recorded.

Preoperative administration of 50 mg of diclofenac could relieve pain and swelling more than the placebo. Additional 10 mg of prednisolone could further reduce swelling.

The combination of diclofenac and prednisolone has a better analgesic and anti-inflammatory effect.