Postoperative Analgesia in Impacted Third Molar Surgery: The Role of Preoperative Diclofenac Sodium, Paracetamol and Lornoxicam

Objective: The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous (i.v.) paracetamol, diclofenac sodium and lornoxicam (nonsteroidal anti-inflammatory drugs). Subjects and Methods: Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P (n = 20), group D (n = 20) and group L (n = 20). Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups. Results: The groups were comparable for pain scores (p > 0.05). Maximum pain scores were recorded in postoperative 4th h in all groups (group L 22, 14–44 mm; group P 24, 13–43 mm; group D 14, 10–24 mm, p = 0.117). Patients experienced high satisfaction scores which were comparable among groups (group L 85, 75–100 mm; group P 87, 70–95 mm; group D 84, 77–98 mm, p = 0.457). Conclusion: Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens.