Comparative study of tramadol combined with dexamethasone and diclofenac sodium in third-molar surgery

The aim of this randomized, double-blind clinical trial was to investigate the effect of preemptive analgesia with a combination of tramadol + dexamethasone or tramadol + diclofenac sodium. The study included 30 patients (age range: 16–30 years), who were randomly assigned to 2 groups by the split-mouth method. Postoperative pain was assessed with a visual analogue scale at 4, 6, 12, 24, and 48 h postoperatively (p.o.h.). Swelling was measured at 48 p.o.h. Maximal interincisor distance was measured at 48 p.o.h. and 7 postoperative days (p.o.d.). Significant differences in postoperative pain intensity were detected between the drug combinations at 4, 6, and 12 p.o.h., suggesting the importance of preemptive analgesia. Patients treated with tramadol + dexamethasone showed lower pain scores compared to the tramadol + diclofenac sodium combination, larger postoperative mouth opening, and less swelling. The tramadol + dexamethasone combination also was more effective than tramadol + diclofenac sodium at reducing inflammation.