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COMPARATIVE'STUDY'OF'ANALGESIC'
EFFECTIVENESS'OF'TRAMADOL'AND'
KETOROLAC'IN'THE'PAIN'
MANAGEMENT'OF'SURGICAL'
REMOVAL'OF'THIRD'MOLAR:'A'
RANDOMIZED'DOUBLE'BLINDED'
STUDY'
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ABSTRACT'
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AIM:)Assessing)the)efficacy)of)drug)in)controlling)pain)intensity)after)
surgical) removal) of) impacted) ) mandibular) third) molar) teeth) and) to)
compare) the) effects.) MATERIAL' AND' METHODS:) A) doubleTblind,)
randomized,)controlled)clinical)trial)was)conducted.)40)patients)were)
randomly) selected) and) divided) into) two) equal) groups.) Group) A)
received) 50) mg) of) tramadol) orally) and) Group) B) received) 10) mg) of)
ketorolac) orally.) In) both) groups) dose) was) repeated) for) next) 24) hrs.)
Visual) analogue) scale) was) used) for) the) collection) of) pain) intensity)
from) the) patients.) RESULTS:) The) results) revealed,) in) Group) A,) the)
analgesia)started)within)1)hour)and)reached)the)maximum)analgesic)
effect) in) 4) hours,) pain) intensity) was) 1.8) out) of) 10,) on) visual) analog)
scale.) In) Group) B,) analgesia) started) within) 1hour) and) showed) its)
maximum) analgesic) effect.) The) pain) intensity) was) 2.5) on) visual)
analog) scale.) The) analgesic) effect) of) 50) mg) tramadol) lasted) up) to) 6)
hours) and) that) of) ketorolac) lasted) for) 5) hour.) CONCLUSION:) The)
study)shows)that)50mg)tramadol)is)a)suitable)and)safe)analgesic)for)
the) relief) of) postTextraction) pain) and) is) more) effective) than) 10mg)
ketorolac) with) prolonged) analgesia) and) minimal) side) effects,) we)
recommend) studies) with) randomized) clinical) trials) with) larger)
sample)size)are)needed)it)in)clinical)practice.)
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CHETHAN,)R*) '
RAMAMUTHY,)TK*) KEYWORDS'
PATIL,)Shilpa*)
)
REDDY,)Satheesha*)
Tramadol.)Ketorolac.)Third)molar.)Impacted.)Extraction.)
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Department)of)Oral)Medicine)&)Radiology,)AECS)Maaruti)Dental)College,)Karnataka,)India*)
Correspondence:)doctor.chethan@gmail.com)(CHETHAN)R))|)Received)17)Jun)2015)Received'in'revised'form)21)Jun)2015)Accepted)28)Jun)2015)
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776
into' the'oral' cavity,' frequently'these' teeth'are' after' mandibular' third' molar' tooth' extraction'
either' partially' impacted' or' completely' for' quicker' recovery' of' the' patient' from' the'
impacted' in' the' jaw' bone.' They' might' not' post' extraction' pain.There' were'some' reports'
always' come' into' the' mouth' normally.' published' the' comparing' the' preemptive'
considered' the' best' and' easiest' method' to' ' Inclusion' criteria' were' as' follows:' age'
the' analgesic' effects' of' two' commonly' used' with'the' subject' third' molar' up' to' the' day' of'
JRD'F'Journal'of'Research'in'Dentistry,'Tubaro,'v.'3,'n.'4,'jul/aug.'2015
777
the' surgery,' and' grade' II' or' III' difCiculty' of' ' The' patients' were' divided' into' two'
extraction. groups' containing' 20' patients' in' each' group.'
' Exclusion' criteria' included' the' use' of' All' the' codes' of' administered' drugs' were'
analgesics' 24' h' before' the' procedure,' history' disclosed' only' after' the' pain' assessment.' The'
of'seizure'disorder,' oral' contraceptive'use,End' group' A' received' tramadol' 50mg' oral' dose'
stage'renal' disease,' known'hypersensitivity'to' after' the' extraction'and' dose' repeated' after' 6'
the'study'medications. hours.' The' group' B' received' ketorolac' 10mg'
' All'surgical'procedures'were'carried'out' oral' dose' after' the' extraction' and' dose' was'
in' the' Department' of' Oral' and' Maxillofacial' repeated'after'6hrs.'Pain'assessment'was'done'
Surgery' by'the' same' surgeon,' and'evaluations' by'verbal'rating'using'visualAnalogue'Scale6'[0'
were' carried' out' by' an' independent' ' no' pain,' 2' F' mild' pain,' 4' F' tolerable,' 6' '
investigator.'Anaesthesia'was'by'nerve'block'of' distressful' pain,' 8' ' severe' pain' and' 10' '
the'lingual,'buccal,'and'inferior'alveolar'nerves' totally'disabling'pain].
using' 2%' lignocaine,' once' anaesthesia' was' ' After' the' tooth' extraction,' drugs' were'
obtained,' surgery' was' started.' DifCiculty' of' given'after'1hour,'the'pain'assessment'at' time'
extraction' was' based' on' a' modiCied' scale' of' points' of' 1hr' after' medication,' 2hr,' 3hr,' 4hr,'
Parant' et' al.7' ' as' follows:' Grade' I,' extraction' 5hr,' 6hrs.' The' patients' vital' signs' including'
with'forceps'and'elevators;'Grade'II,' extraction' heart'rate,' respiratory'rate'and'blood'pressure'
by' osteotomy;' Grade' III,' extraction' by' were' recorded' at' every' time' point' after' the'
osteotomy' and' coronal' section;' Grade' IV,' assessment'of'pain'intensity.
extraction' by' osteotomy,' root' and' coronal' ' Qualitative' variable' data' are' expressed'
section;'Grade'V,' complex'extraction;'Grade'Vl,' as'percentages'or'proportions.'T'test'was'used'
extraction' with' special' techniques.' In' each' for' statistical' analysis.- A' difference' was'
patient,' impacted' mesio' angular' mandibular' considered' statistically' not' signiCicant' in' 1st,'
third' molar' with' grade' II' or' III' difCiculty' was' 2nd,' 3rd' hr' it' was' more' than'5%' (p>0.05),' 4th,
extracted. 5th,' 6th' hr' was' statistical' signiCicant'it'was'less'
' The' individuals' were' unaware' of' the' than'5%'(p<0.05).
analgesic' which' they' had' taken' during' the'
study.'The'drugs'ketorolac'10mg'and'tramadol'
RESULTS
50mg' were' procured' from' the' pharmacy' and'
! In' our' study,' the' analgesic' effect' for'
they'have'been'assigned'a'code.'Patients' were'
group' A' who' were' taken' tramadol' started'
randomly'assigned'in'either' treatment' groups'
within' 1st' hour' and' reached' the' maximum'
with'an'assigned'code.'
analgesic' effect' in'4'hours.' The' average'rating'
JRD'F'Journal'of'Research'in'Dentistry,'Tubaro,'v.'3,'n.'4,'jul/aug.'2015
778
JRD'F'Journal'of'Research'in'Dentistry,'Tubaro,'v.'3,'n.'4,'jul/aug.'2015
779
Sh
aik
'et
'al
14.
'From
'th
e'cu
rren
t's
tudy
'it
'ha
s' t
ram
ado
l
'an
alg
esi
c'e
ffe
ct's
tar
ted
'af
ter
'1'hou
r'
b
een
'prov
ed'th
at'bo
th'th
e'd
rug
s'a
re'g
ivin
g' and
'su
sta
ined
'fo
r'
the
'
lon
ger
't
ime
'i
.e
.'mo
re'
than
'
b
ett
er'an
alg
esi
c'e
ffe
ct
.'K
eto
rol
ac'
is
'show
ing
'i
ts
' 6
'hou
rs'
(Fi
gur
e'1
).
'
an
alg
esi
c'e
ffe
ct
've
ry'r
apid
ly
'bu
t'th
e'a
ction
'
su
sta
ined
'on
ly' up
'to
'4' hou
rs.
' Whe
rea
s'
F
igu
re'1
.
'Comp
ari
son
'of
'pa
in'
int
ens
it
ies
'of
'Tr
amado
l
'and
'Ke
toro
lac
.
CONCLUS
ION REFERENCES
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a'
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'wi
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