Comparative analgesic effects of Ibuprofen, Celecoxib and Tramadol after third molar surgery: A prospective comparative study

Abstract

This prospective comparative study included 200 healthy subjects who required surgical extraction of impacted mandibular third molars. The subjects were randomized into three equal groups and given appropriate doses of each drug immediately after extraction. They continued the drugs up to 48 hours after the extraction. Postoperative pain intensity was self-recorded by subjects at 4, 8, 16, 24 and 48 hours after the extraction, using a visual analogue scale (VAS). The mean VAS at each point of postoperative pain assessment was compared using one-way analysis of variance (ANOVA) among the three groups. The mean VAS score of the Celecoxib group (37.77) at 4 hours was the lowest. This was followed by the ibuprofen group with a mean VAS score of 44.20 Whereas, the subjects in the Tramadol group experienced the highest VAS score (58.26) at 4 hours. There was a statistically significant difference in the mean VAS scores at 4 hours after extraction when the three groups were compared (p = 0.0039). Celecoxib group also had the lowest mean VAS score. Celecoxib was the most effective analgesic of the three studied drugs in controlling postoperative pain after mandibular third molar extraction in our subjects. It was closely followed by ibuprofen while Tramadol was found to be the least effective. The outcomes of this study suggest that celecoxib can be prescribed for effective control of postoperative pain after third molar surgery. It also shows that ibuprofen can be an analgesic of choice for patients who are not at risk of gastrointestinal complications of non-steroidal anti-inflammatory drugs (NSAIDs).