Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery

Babatunde Olamide Bamgbose, Jelili Adisa Akinwande, Wasiu Lanre Adeyemo, Akinola Ladipo Ladeinde, Godwin Toyin Arotiba, Mobolanle Olugbemiga Ogunlewe, Babatunde Olamide Bamgbose, Jelili Adisa Akinwande, Wasiu Lanre Adeyemo, Akinola Ladipo Ladeinde, Godwin Toyin Arotiba, Mobolanle Olugbemiga Ogunlewe

Abstract

Background: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial inflammatory and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered dexamethasone and diclofenac potassium (diclofenac K) with diclofenac K alone on the postoperative pain, swelling and trismus after surgical removal of third molars.

Patients and methods: A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria. A total of 100 patients were randomly allocated to two treatment groups of dexamethasone (prophylactic 8 mg and postoperative 4 mg IV) and diclofenac K (50 mg Oral before and after surgery), and diclofenac K alone (as with first group). The overall analgesic efficacy of the drug combinations was assessed postoperatively by determination of pain intensity using a category rating scale. Facial swelling was measured using a tape measure placed from tragus to gonion to tragus, while interincisal mouth-opening of patients was measured using a vernier calibrated caliper pre-operatively and post-operatively.

Results: Co-administration of dexamethasone and diclofenac K was significantly superior to diclofenac alone for the relief of pain (P < 0.05), and facial swelling up to post-operative 48 hour (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05).

Conclusion: This study illustrates enhanced effects of co-administered dexamethasone and diclofenac K on short-term post-operative pain and swelling, compared to diclofenac potassium alone in third molar surgery.

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