Analgesic efficacy of tramadol/dexketoprofen vs Ibuprofen after impacted lower third molar extraction: a randomized controlled clinical trial Vallecillo, Cristina Vallecillo Rivas, Marta Gálvez Mateos, Rafael Vallecillo Capilla, Manuel Francisco Olmedo Gaya, María Victoria Pain management Analgesia Acute pain Multimodal treatment Oral surgery Objective Impacted third molar extraction is associated with acute moderate-to-severe pain for up to 48 hours post-surgery. This trial was designed to compare the analgesic effectiveness, swelling, and adverse events after impacted third molar surgery following multimodal therapy with 75 mg tramadol hydrochloride plus 25 mg dexketoprofen or monotherapy with 400 mg ibuprofen. Methods Seventy-two patients were randomly assigned to receiving ibuprofen (n = 36) or tramadol-dexketoprofen (n = 36). Postoperative pain intensity and swelling were measured using a visual analog scale (VAS); pain relief experienced was reported using a 4-point verbal rating scale; the rescue medication requirement, adverse effects, and global impression of the medication were recorded. Results No statistically significant between-group difference in pain intensity was observed at any time point; however, pain relief was significantly higher in the tramadol-dexketoprofen treated-group at 6 and 36 hours. Self-reported verbal rating scale assessments showed significantly lower swelling in the tramadoldexketoprofen group at 24 hours post-surgery but not at 48 or 72 hours, and VAS- swelling scores showed no significant between-group difference. The frequency of postoperative nausea and dizziness was significantly higher in the tramadoldexketoprofen group. Conclusions Multimodal therapy proved more effective to manage moderate-severe pain after impacted third molar surgery in comparison to monotherapy. However, the improvement in relief must be balanced against the increased risk of adverse effects when considering this multimodal approach. 2023-03-07T12:57:36Z 2023-03-07T12:57:36Z 2021-07-28 journal article CRISTINA VALLECILLO... [et al.]. ANALGESIC EFFICACY OF TRAMADOL/DEXKETOPROFEN VS IBUPROFEN AFTER IMPACTED LOWER THIRD MOLAR EXTRACTION: A RANDOMIZED CONTROLLED CLINICAL TRIAL, Journal of Evidence Based Dental Practice, Volume 21, Issue 4, 2021, 101618, ISSN 1532-3382, [https://doi.org/10.1016/j.jebdp.2021.101618] https://hdl.handle.net/10481/80458 10.1016/j.jebdp.2021.101618 eng http://creativecommons.org/licenses/by-nc-nd/4.0/ open access Attribution-NonCommercial-NoDerivatives 4.0 Internacional Elsevier