Comparison of Pain Determination Between Celecoxib Tramadol in Third Molar Surgery: Comparative Pain Management

Eshnawar Ishaque; Suneel Kumar Punjabi; Mahavosh Qazi; Faiza Hasan; Zunair Akbar Memon; Sadia Hassan; Salman Shams

doi:10.54393/pjhs.v5i06.1532

Authors

Eshnawar Ishaque Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Suneel Kumar Punjabi Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Mahavosh Qazi Department of Oral Medicine, Sir Syed Medical and Dental College, Karachi, Pakistan
Faiza Hasan Department of Pharmacology, Fatima Jinnah Dental College, Karachi, Pakistan
Zunair Akbar Memon Department of Oral Medicine, Isra Dental College, Hyderabad, Pakistan
Sadia Hassan Department of Oral Biology, Isra Dental College, Hyderabad, Pakistan
Salman Shams Department of Oral Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i06.1532

Keywords:

Postoperative Pain, Maxillofacial, Third Molar Surgery, Celecoxib, Tramadol

Abstract

Selecting a reliable and well-tolerated analgesic to manage pain after surgical extraction of the third molar is still a difficult task. Objective: To compare the effect of celecoxib and tramadol in managing post-operative pain following third molar surgery. Methods: This cross-sectional research was conducted at the Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. A total of 100 patients were included and equally allocated into two groups. Group-A received celecoxib, and Group-B received tramadol. Patients were assessed on follow-up visits on the 1st, 3rd, and 5th days post-surgery. Results: Data revealed a mean age of 28.72 ± 3.844 years for Group-A (celecoxib), consisting of 30 (60%) males and 20 (40%) females out of 50 respondents. Group-B (Tramadol) exhibited a mean age of 28.28 ±3.511 years, including 29 (58%) males and 21 (42%) females. Preoperational and 1st day post-operational pain scores were similar for celecoxib and tramadol (median 8), with no significant difference (p-value= 0.180 and p-value= 0.874). By the 3^rd day, celecoxib patients reported significantly lower pain (median 3, IQR 2-4) compared to tramadol (median 5, IQR 4-6), p<0.001. On the 5th day, celecoxib also had significantly lower pain (median 0, IQR 0-1) than tramadol (median 1, IQR 0-2), p<0.001. Conclusions: The study concludes that celecoxib is more effective than tramadol in mitigating pain following third molar surgery.

References

Jeyashree T and Kumar MS. Evaluation of difficulty index of impacted mandibular third molar extractions. Journal of Advanced Pharmaceutical Technology & Research. 2022 Nov; 13(1): S98-101. doi: 10.4103/japtr.japtr_362_22. DOI: https://doi.org/10.4103/japtr.japtr_362_22

Ayub K, Fazal M, Sattar M, Khan L, Malik A, Afzaal A. Pattern of Mandibular Third Molar Impaction in Patients from Twin Cities of Pakistan. Journal of Women Medical and Dental College. 2023 Jan; 2(2). doi: 10.56600/jwmdc.v2i2.74. DOI: https://doi.org/10.56600/jwmdc.v2i2.74

Khalid A, Khan MA, Punjabi SK, Manzoor U, Aslam MA, Shams S. Evaluation of anxiety and hemodynamic changes in surgical removal of lower third molar under local anesthesia. The Professional Medical Journal. 2024; 31(01): 78-83. doi: 10.29309/TPMJ/2024.31.01.7886. DOI: https://doi.org/10.29309/TPMJ/2024.31.01.7886

Lee CT, Zhang S, Leung YY, Li SK, Tsang CC, Chu CH. Patients' satisfaction and prevalence of complications on surgical extraction of third molar. Patient Preference and Adherence. 2015 Feb; 9: 257-63. doi: 10.2147/PPA.S76236. DOI: https://doi.org/10.2147/PPA.S76236

Bassyoni L. Comparative Effect of Celecoxib, Diclofenac, and Ibuprofen in Controlling Postoperative Pain, Edema, and Trismus After Third Molar Extraction: A Double-Blinded Randomized Controlled Trial. Cureus. 2024 Feb; 16(2): e53687. doi: 10.7759/cureus.53687. DOI: https://doi.org/10.7759/cureus.53687

Gonçalves KK, dos Santos MS, da Silva Barbirato D, Silva CC, de Barros AV, de Araújo ES et al. Is the injection of tramadol effective at control of pain after impacted mandibular third molar extractions? A systematic review and meta-analysis. Medicina Oral Patología Oral Y Cirugía Bucal. 2022 Nov; 27(6): e560. doi: 10.4317/medoral.25498. DOI: https://doi.org/10.4317/medoral.25498

Miroshnychenko A, Ibrahim S, Azab M, Roldan Y, Martinez JP, Tamilselvan D et al. Acute postoperative pain due to dental extraction in the adult population: a systematic review and network meta-analysis. Journal of Dental Research. 2023 Apr; 102(4): 391-401. doi: 10.1177/00220345221139230. DOI: https://doi.org/10.1177/00220345221139230

Gonzalez-Barnadas A, Camps-Font O, Martin-Fatas P, Figueiredo R, Gay-Escoda C, Valmaseda-Castellon E. Efficacy and safety of selective COX-2 inhibitors for pain management after third molar removal: a meta-analysis of randomized clinical trials. Clinical Oral Investigations. 2020 Jan; 24: 79-96. doi: 10.1007/s00784-019-02910-3. DOI: https://doi.org/10.1007/s00784-019-02910-3

Gascon N, Almansa C, Merlos M, Miguel Vela J, Encina G, Morte A et al. Co-crystal of tramadol-celecoxib: preclinical and clinical evaluation of a novel analgesic. Expert Opinion on Investigational Drugs. 2019 May; 28(5): 399-409. doi: 10.1080/13543784.2019.1612557. DOI: https://doi.org/10.1080/13543784.2019.1612557

Isiordia-Espinoza MA, Gómez-Sánchez E, Mora-Falcón IJ, Amador-Beas IA, Hernández-Gómez A, Serafín-Higuera NA et al. Analgesic Efficacy of COX-2 Inhibitors in Periodontal Surgery: A Systematic Review and Meta-Analysis. InHealthcare. 2023 Apr; 11(7): 1054. doi: 10.3390/healthcare11071054. DOI: https://doi.org/10.3390/healthcare11071054

Drini M. Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Australian Prescriber. 2017 Jun; 40(3): 91. doi: 10.18773/austprescr.2017.037. DOI: https://doi.org/10.18773/austprescr.2017.037

Gay-Escoda C, Hanna M, Montero A, Dietrich T, Milleri S, Giergiel E et al. Tramadol/dexketoprofen (TRAM/DKP) compared with tramadol/paracetamol in moderate to severe acute pain: results of a randomised, double-blind, placebo and active-controlled, parallel group trial in the impacted third molar extraction pain model (DAVID study). British Medical Journal Open. 2019 Feb; 9(2): e023715. doi: 10.1136/bmjopen-2018-023715. DOI: https://doi.org/10.1136/bmjopen-2018-023715

Vranckx M, Fieuws S, Jacobs R, Politis C. Prophylactic vs. symptomatic third molar removal: effects on patient postoperative morbidity. Journal of Evidence Based Dental Practice. 2021 Sep; 21(3): 101582. doi: 10.1016/j.jebdp.2021.101582. DOI: https://doi.org/10.1016/j.jebdp.2021.101582

Zamiri B, Mousavizadeh K, Taj Am, Mohammadi Nc, Aarabi AM. Comparison of ibuprofen, celecoxib and tramadol in relief of pain after extraction of mandibular third molar teeth. Journal of Iranian Red Crescent Medical Journal. 2009; 11(4): 431-436.

Bauer HC, Duarte FL, Horliana AC, Tortamano IP, Perez FE, Simone JL et al. Assessment of preemptive analgesia with ibuprofen coadministered or not with dexamethasone in third molar surgery: a randomized double-blind controlled clinical trial. Oral and Maxillofacial Surgery. 2013 Sep; 17: 165-71. doi: 10.1007/s10006-012-0360-7. DOI: https://doi.org/10.1007/s10006-012-0360-7

Hanzawa A, Handa T, Kohkita Y, Ichinohe T, Fukuda KI. A comparative study of oral analgesics for postoperative pain after minor oral surgery. Anesthesia Progress. 2018 Mar; 65(1): 24-9. doi: 10.2344/anpr-65-01-02. DOI: https://doi.org/10.2344/anpr-65-01-02

Kumar GP, Shu-Lyn C, Win GE, Sie LW, binti Lakman NF, Haque N. Comparison between preoperative and post-operative administration of paracetamol, ibuprofen and mefenamic acid for post-extraction pain control. Biomedical Research and Therapy. 2020 May; 7(5): 3794-8. doi: 10.15419/bmrat.v7i5.606. DOI: https://doi.org/10.15419/bmrat.v7i5.606

Jung YS, Kim MK, Um YJ, Park HS, Lee EW, Kang JW. The effects on postoperative oral surgery pain by varying NSAID administration times: comparison on effect of preemptive analgesia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2005 Nov; 100(5): 559-63. doi: 10.1016/j.tripleo.2005.02.065. DOI: https://doi.org/10.1016/j.tripleo.2005.02.065

Sener M, Pektas ZO, Yilmaz I, Turkoz A, Uckan S, Donmez A et al. Comparison of preemptive analgesic effects of a single dose of nonopioid analgesics for pain management after ambulatory surgery: A prospective, randomized, single-blind studyin Turkish patients. Current Therapeutic Research. 2005 Nov; 66(6): 541-51. doi: 10.1016/j.curtheres.2005.12.001. DOI: https://doi.org/10.1016/j.curtheres.2005.12.001

Akinbade AO, Ndukwe KC, Owotade FJ. Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: A double blind randomized controlled trial. Nigerian Journal of Clinical Practice. 2019 Jun; 22(6): 796-800. doi: 10.4103/njcp.njcp_544_18. DOI: https://doi.org/10.4103/njcp.njcp_544_18