Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations

Abstract

Objectives:To compare the effectiveness of different oral analgesics for relieving pain and distress in adults following the extraction of teeth and deep cavity preparations under local anesthesia.Methods:This randomized controlled study was conducted between November 2015 and May 2016. One hundred and twenty patients were randomly allocated to 3 groups. Forty patients were in the paracetamol (1 gram) group, 40 in the ibuprofen (400 mg) group and 40 in the diclofenac potassium (50 mg) group. Evaluation of the post extraction and deep cavity preparations pain was made by patients immediately postoperatively, 2, 4 and 6 hours postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, each patient was observed preoperatively and immediately postoperatively for signs of distress by using a 5 point face scale.Results:There were significant decreases in mean pain VAS scores for diclofenac potassium group compared to paracetamol and ibuprofen groups at 4 hours postoperatively (one-way Analysis of Variance: p=0.0001, p=0.001) and 6 hours postoperatively (p=0.04, p=0.005). Changes in distress scores from the preoperative score to the postoperative score were made using the paired sample t-test. There were significant decreases in distress scores between the preoperative and postoperative scores (p=0.0001).Conclusions:Diclofenac potassium was more effective than paracetamol or ibuprofen for reducing postoperative pain associated with tooth extraction and deep cavity preparation. Patients’ distress levels can be alleviated by using preemptive analgesics.

Loxoprofen Sodium Versus Diclofenac Potassium for Post-Dental Extraction Pain Relief: A Randomized, Triple-Blind, Clinical Trial

“…The pain assessment was carried out 6 hours post-dental extraction and every 12 h thereafter on the same day of extraction and the following two days, because the highest pain point is between 6 to 8 h after extraction and intensity of pain has been shown to reach its maximum in the first 24 h [5,6]. The pain assessment was recorded by the patient via a questionnaire (data collecting sheet) using the Visual Analogue Scale (VAS).…”

“…As discussed, two randomly distributed analgesics (loxoprofen sodium and diclofenac potassium) were used in this study. Loxoprofen sodium (Roxonin 60 mg) is a tablet used for post-extraction pain and inflammation [12], and diclofenac potassium (Rapidus 50 mg) is used to relieve pain and swelling (inflammation) [6].…”

“…Post-operative pain intensity can be decreased with the use of a pre-operative analgesic, as the amount of pain triggers prostaglandins discharged into the site of the injuries is reduced. Accumulation of prostaglandins released from the injured tissues increases over time and leads to the amplification of pain intensity [6]. Prostaglandins play a vital role in mediating inflammatory pain by lowering the pain threshold of polymodal transient vanilloid receptors (TRPV1) [7].…”

“…Notably, in Saudi Arabia, diclofenac potassium was found to be more effective than paracetamol or ibuprofen for moderate to severe post-operative pain [6]. The limitation of the aforementioned study was the sample size and that it included only male patients, which may have affected the study results [6]. It has been reported that females have a higher pain rating, less tolerance of noxious stimuli than males and a greater ability to discriminate pain.…”

“…Diclofenac potassium 50 mg is a tablet that contains diclofenac potassium as an active ingredient. Diclofenac potassium tablets are generally used to relieve pain and swelling (inflammation) in various mild to moderate painful conditions such as dental pain, back pain, general pain and swelling, gout attacks, sports injuries and muscle aches [6].…”