Efficacy of Piroxicam and Tramadol as a Pre-Emptive Analgesic Agent for Mandibular Third Molar Surgery

Objectives: The purpose of this clinical trial is to examine the effectiveness of 20 mg piroxicam with 50 mg tramadol as a pre-emptive analgesic for mandibular third molar surgery.

Methods: In this prospective study, 30 patients were referred to the Department of Oral and Maxillofacial Surgery in Chennai for surgical removal of impacted mandibular third molars with similar difficulty indexes under local anesthetic. Patients were randomly distributed to one of two groups: Group A received 20 mg piroxicam intramuscularly (IM) 50 minutes before surgery, while Group B received 50 mg tramadol IM 50 minutes before surgery. The time to analgesic re-medication, Pain intensity (VAS Scores) at 1st, 2nd, 12th, 24th hour, total analgesic consumption was evaluated.

Results: When compared to the group getting 50 mg of tramadol IM, the group receiving 20 mg of piroxicam IM demonstrated differences in pain intensity as measured by the visual analog scale and total analgesic consumption [lesser values], and the results were statistically significant(p<0.05). However, there were no statistically significant differences between the two groups in terms of time to first rescue analgesic medication, number of patients requiring the rescue analgesic procedure (10 mg of oral ketorolac), and number of patients without the need for analgesic during the evaluation period. (P >0 .05).

Conclusion: Within the limits of the study, patients who received 20 mg of piroxicam before surgery had less pain intensity and total analgesic consumption than those who received 50 mg of tramadol before surgery. In comparison to pre-emptively administered tramadol, piroxicam showed superior analgesic effects for intermediate surgical operations when given preoperatively.