Effect of submucosal administration of tramadol on postoperative pain after third molar surgery

Purpose: The aim of this study was to evaluate the effects of submucosal administration of tramadol (centrally acting opioid) on acute postoperative facial pain, visual analogue scale values and non steroidal analgesic drug usage after extraction of submerged third molar teeth. Methods: This prospective randomized double-blind placebo-controlled study, included 60 American Society of Anesthesiologists (ASA) I-II patients having impacted third molar extraction operation. Patients were divided into two groups after extraction of impacted third molars under local anesthesia. In the treatment group, 1mg/kg tramadol was administered to patients submucosally after extraction, and in the control group, 2 ml saline was administered to patients submucosally. The evaluations of the VAS scores were done at 30. min, 1., 2., 4., 6., 12., 24. and 48th hours after extractions. The time at which the first analgesic drug was taken, total analgesic dose that was used and adverse drug reactions were also evaluated. Results: In the treatment group, postoperative 30. min., 1., 2., 4., 6. and 12. hour VAS values were statistically lower than that was observed in the control group (p<0.05). Time to the first analgesic drug in the treatment group was longer than that was recorded for the control group S (p<0.01) and in the treatment group total analgesic dose was statistically lower than that of the control group (p<0.01). Conclusion: We conclude that postoperative, submucosal administration of tramadol to operation area is a reliable and effective method for the prevention of acute postoperative facial pain after surgical removal of impacted third molars.