EFFECTS OF CO-ADMINISTRATION OF DEXAMETHASONE AND DICLOFENAC SODIUM ON THE POST-OPERATIVE OUTCOMES FOLLOWING MANDIBULAR THIRD MOLAR SURGERY UNDER LOCAL ANAESTHESIA

*Abd Allah Ibrahim Abd Alrahman Mudawi and M. A. Higzi

ABSTRACT

Background: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids imply 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 sodium (diclofenac Na) with diclofenac Na alone on the postoperative pain, swelling and trismus after surgical removal of mandibular third molars. Patients and Methods: A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, minor surgery clinic at Khartoum Teaching Dental Hospital, Sudan. A total of 120 patients were randomly allocated to three treatment groups; dexamethasone (8mg IV preoperative) and diclofenac Na (75 mg IM preoperatively) group, diclofenac Na alone group (75mg IM preoperatively) and the third group as a control group without medication. The overall analgesic effectiveness of the drug combinations was assessed postoperatively by determination of pain intensity using a visual analogue 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 metallic ruler preoperatively and post-operatively. Results: Co-administration of dexamethasone and diclofenac Na was significantly superior to Diclofenac Na alone for the relief of pain (P < 0.05) and facial swelling (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05). Conclusion: This study demonstrate enhanced effects of co-administered dexamethasone and diclofenac Na on short-term post-operative pain and swelling, compared to diclofenac sodium alone in mandibular third molar surgery.

Keywords: diclofenac Na, 8mg IV preoperayive, 75mg IM preoperatively.