A Comparative Study Of Oral Analgesics: Etoricoxib With Tramadol In Acute Postoperative Pain: A Randomised Double Blind Study
Background: Etoricoxib is known to be a selective inhibitor of the cox-2 enzyme. It is an effective analgesic, associated with a reduced risk of bleeding due to platelet dysfunction, gastrointestinal bleeds and ulcers. Studies on etoricoxib in the dental extraction pain model have proved the superior efficacy of etoricoxib with fewer adverse effects as compared to oxycodone/acetaminophen.
Aims: The aim of this study was to compare the efficacy and tolerability of oral etoricoxib 120mg with oral tramadol 100 mg in postoperative pain. This comparison will help to determine the rapidity and sustained efficacy of these agents in pain relief and the possible side effects attributable to the medications.
Settings and Design: The study was conducted among 60 patients with one or more impacted third molar teeth, posted for extraction at the oral surgery department of the Vinayaka Missions Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu. Patients selected for the study were randomized by a computer generated list using random allocation software and were given a sequentially-numbered sealed opaque envelope containing the study drugs by the blinded investigator.
Methods and Material: Pain assessment was done by assessing the following: mean pain scores using a 10 point VAS scale, investigator assessment of ancillary clinical outcomes, inflammation, opening of the mouth, global assessment of study medications and the incidence of adverse effects.
Statistical Analysis used: The statistical analysis was done by using the paired preference test. Unpaired t test was used to compare the mean VAS score values from day 0 to day 5.
Results and Conclusions: The frequency of the inflamed condition at day 0 to the uninflammed condition at day 5 was 86.67% and 70% respectively for etoricoxib and tramadol. Statistically, etoricoxib was preferred to tramadol by a T score of 0.667 (50% confidence). The frequency of lack of pain was found to be predominant in etoricoxib as compared to tramadol (93.34% versus 60%). Preferential analysis showed a clear preference for etoricoxib, with a T score of 1.219, significant at a 77% confidence level. Etoricoxib had a superior effect over tramadol in terms of anti-inflammatory and analgesic properties. Patients receiving cox-2 inhibitors had a lower incidence of gastritis and drowsiness as compared to patients receiving tramadol.