The Efficacy of Pre-emptive Analgesia in Controlling Postoperative Pain in Lower Third Molar Surgery: a Clinical Trial

Objective: The aim of this study was to evaluate the analgesic efficacy of preoperative versus postoperative administration of diclofenac sodium in the prevention of the postoperative pain following a lower third molar surgery. Methods: A prospective randomized clinical trial was conducted on 73 patients who underwent surgical extraction of bilateral fully impacted lower third molars. Patients were randomised into two groups: group I were started on diclofenac sodium postoperatively, and group II were started on diclofenac sodium preoperatively, both groups were then prescribed a diclofenac sodium regimen for three days postoperatively and were advised to resort to an additional analgesic (paracetamol/codeine tablets) as a rescue medication when adequate relief from pain was not achieved. The analgesic efficacy of both regimens was tested. Results: Results showed a significant difference between the two groups in terms of the analgesic efficacy in the first postoperative day. Significantly less pain and less need for additional analgesia was recorded in group II (p<0.05). Conclusion: Preoperative treatment with diclofenac sodium provides effective relief from acute mild to moderate pain following third molar surgery compared to its postoperative administration.