Comparison of the Effects of Daily Single Dose Use of Flurbiprofen, Diclofenac Sodium and Tenoxicam On Postoperative Pain, Swelling and Trismus: A Randomized Double-Blind Study

Abstract Purpose The aim of this study is to compare the effects of daily single dose use of flurbiprofen, diclofenac sodium and tenoxicam on pain, swelling and trismus that occur following surgical extraction of impacted wisdom teeth under local anesthesia. Methods The study included three groups with 30 individuals in each group. Individuals volunteering to participate in this double-blind randomized study (n=90) were selected from among a patient population for whom there was indication for extraction of impacted wisdom teeth. In Group 1 patients received 200 mg flurbiprofen, in Group 2 patients received 100 mg diclofenac sodium, and in Group 3 patients received 20 mg tenoxicam all once a day, starting preoperatively. Evaluation of pain was performed postoperatively at 1st, 2nd, 3rd, 6th, 8th, 24th hours and on 2nd and 7th days using VAS. For comparison with the preoperative measurements patients were invited to postoperative 2nd and 7th day controls in order to evaluate swelling and trismus. Descriptive statistics in statistical analysis was obtained via SAS 9.4 software. Statistical analysis of pain, swelling and trismus datas were made via Kruskall-Wallis, Dunn’s test, Wilcoxon–Mann Whitney U test. Statistical level of significance was accepted as 0.05 and power as 0.80. Results Clinically, tenoxicam showed better analgesic and anti-inflammatory efficacy compared to diclofenac sodium and particularly flurbiprofen. While VAS scores in evaluation of pain showed statistically significant difference on 2nd day, there was not statistically significant difference for swelling and trismus. Conclusion Our study evaluates analgesic and anti-inflammatory effects with daily single dose of flurbiprofen, diclofenac sodium and tenoxicam. In conclusion, daily 20 mg tenoxicam can be accepted as an adequate and safe option for clinicians after surgical procedures.