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Transdermal diclofenac versus oral paracetamol-ibuprofen combination for postoperative pain following surgical extraction of mandibular third molar: a randomized controlled trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background: Postoperative pain management following surgical extraction of mandibular third molars require effective analgesic options with favorable safety profiles. This study compares the analgesic efficacy and side effect profiles of a transdermal diclofenac patch versus oral combination of paracetamol and ibuprofen. Materials and methods: Total of 108 patients indicated for surgical extraction of mandibular third molars were randomized into two groups: Group-A ( n = 54) received an oral combination of paracetamol (500 mg) and ibuprofen (400 mg), and Group-B ( n = 54) received a diclofenac transdermal patch (200 mg). Pain [numeric rating scale (NRS)], rescue analgesics, and side effects were assessed at 12, 24, and 72 hours postoperatively. Data were analyzed using descriptive statistics and inferential analysis, including independent t -test, analysis of variance, and chi-square test, with a significance threshold at P < 0.05. Results: Both groups showed significant pain scores reduction over time. Mean NRS scores at 12, 24 and 72 hours were 3.06, 1.15, and 0.69 (Group-A) vs. 3.46, 1.22, and 0.67 (Group-B) respectively with no statistically significant differences in pain scores between two groups at any time. However, the incidence of side effects, particularly gastric irritation, was significantly higher in Group-A compared to Group-B. Conclusion: Both the transdermal diclofenac patch and the oral combination of paracetamol and ibuprofen are effective in managing postoperative pain following mandibular third molar extraction. However, the transdermal diclofenac patch has significantly fewer gastrointestinal side effects, making it a preferable option for patients at risk of gastric irritation.

Source: Annals of Medicine and Surgery

DOI: 10.1097/ms9.0000000000004076