Oral Preemptive Analgesic Efficacy in Post Operative Pain, Nausea and Vomiting in Third Molar Removal Surgery - A Randomised Control Trial

Abstract

Objective: This randomized controlled clinical trial aimed to evaluate the efficacy of oral preemptive analgesia in reducing postoperative pain, nausea, and vomiting following third molar extraction.

Methods: A randomized, single-blind, placebo-controlled clinical trial was conducted with 129 patients requiring surgical removal of impacted mandibular third molars. Participants were divided into two groups: Group A (Test, n=69) received oral aceclofenac 100 mg, paracetamol 325 mg, and serratiopeptidase 15 mg as a combination 60 minutes before surgery. Group B (Control, n=60) received a Vitamin C tablet as placebo. Postoperative pain levels were assessed using a visual analog scale (VAS) at 1, 6, 12, 24, 48, and 72 hours post-surgery. Rescue analgesic consumption and time to first analgesic intake were also recorded.

Results: Patients in Group A reported significantly lower pain scores at all time points (p < 0.05). The need for rescue analgesics was lower in the test group, and the time to first analgesic intake was longer compared to the control group. The incidence of nausea and vomiting was also markedly reduced in Group A, with fewer participants requiring rescue antiemetics compared to Group B (p<0.05). Additionally, participants in Group A demonstrated a quicker return to normal activities.

Conclusion: Preemptive oral analgesia significantly reduced postoperative pain and the incidence of nausea and vomiting following third molar surgery. This strategy could improve patient comfort and recovery, suggesting its utility as part of routine perioperative management in the field of oral surgery.