Effect of submucosal injection of ketorolac versus dexamethasone on postoperative pain after third molar surgery: a randomized clinical trial

Abstract

Background: One of the most common dentoalveolar surgeries is the removal of impacted third molars. Moderate to severe pain is predictable after these surgeries, usually leaving the patient in need of an effective analgesic for at least 24 h. Corticosteroids and NSAIDs are well-known medications used to reduce pain. This prospective, randomized clinical trial aimed to assess the effectiveness of two types of analgesics, ketorolac and dexamethasone, on pain experienced after unilateral impacted third molar surgery. The analgesics were injected sublingually after profound anesthesia was confirmed in 60 healthy adult patients. During this study, the patients were divided into three groups. The patients in group K received 1 mL of ketorolac (30 mg), while the patients in group D received 1 mL of dexamethasone (4 mg) sublingually. The patients in group C (the control group) received 1 mL of normal saline solution as a placebo. Results: The mean pain scores reported by the patients in groups K and D were significantly lower than group C (P = 0.002 and P < 0.001, respectively). However, the difference between groups D and K was not significant (P = 0.158). The mean number of analgesics taken by patients in groups K and D 24 h after surgery was significantly lower than the control group (P < 0.05). At 48 and 72 h postoperatively, however, the difference was not significant between the study groups (P > 0.05). The mean time of the first analgesic taken by the patients in groups K and D was 200.94 and 214.74 min after surgery, respectively. Exhibiting a significant difference, it was 132.65 min for the patients in group C (P = 0.003). Conclusions: Under this study's limitations, preoperative sublingual injection of ketorolac and dexamethasone were similarly effective in pain control after impacted third molar surgery.