Cahit Üçok

Postoperative analgesia in impacted third molar surgery: the role of preoperative diclofenac sodium, paracetamol and lornoxicam.

Objective: The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous (i.v.) paracetamol, diclofenac sodium and lornoxicam (nonsteroidal anti-inflammatory drugs). Subjects and Methods: Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P (n = 20), group D (n = 20) and group L (n = 20). Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups. Results: The groups were comparable for pain scores (p > 0.05). Maximum pain scores were recorded in postoperative 4th h in all groups (group L 22, 14–44 mm; group P 24, 13–43 mm; group D 14, 10–24 mm, p = 0.117). Patients experienced high satisfaction scores which were comparable among groups (group L 85, 75–100 mm; group P 87, 70–95 mm; group D 84, 77–98 mm, p = 0.457). Conclusion: Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens.

Stereophotogrammetric assessment of the effect of tenoxicam on facial swelling subsequent to third molar surgery

The present study was undertaken in order to evaluate the effects of tenoxicam (Tilcotil®), 20 mg daily, versus placebo on the inflammatory response induced in patients undergoing surgical removal of bilateral lower third molar teeth, using stereophotogrammetry to assess the degree of swelling. The results indicated that tenoxicam (20 mg/day) was no more effective than a nonactive placebo in modifying swelling in the first two postoperative days.