Pre-emptive analgesic effect of tramadol after mandibular third molar extraction: a pilot study.

Author(s): Pozos-Guillen A, Martinez-Rider R, Aguirre-Banuelos P, Perez-Urizar J

Affiliation(s): Department of Oral and Maxillofacial Surgery, Facultad de Estomatologia, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico.

Publication date & source: 2007-07, J Oral Maxillofac Surg., 65(7):1315-20.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: We compared the efficacy of tramadol given before or immediately after surgical extraction of an impacted mandibular third molar under local anesthesia. MATERIALS AND METHODS: In this prospective, randomized, controlled, double-blind pilot study, 3 groups of 20 patients each were included: tramadol preoperative, 100 mg intramuscularly (IM) 1 hour before surgery (group A); tramadol postoperative, 100 mg IM immediately after surgery (group B); and saline (group C). We evaluated intensity of pain and analgesic consumption as was requested. RESULTS: The analgesic efficacy measured as complete relief of pain at 24 hours was 86% in the preemptive tramadol compared with 70% and 36% for postoperative tramadol administration and control group. A significant reduction in the consumption of analgesics was seen in preoperative group as compared with the postoperative and control groups. Adverse events were minimal and similar in all groups. CONCLUSIONS: This study suggests the preemptive use of tramadol as an alternative for the acute pain treatment after the removal of an impacted mandibular third molar carried out under local anesthesia.