Azhar Malik, Rudra Kaul, Vibhuti Kaul<\/p>\n
ABSTRACT Introduction: Pulp exposure as a sequel of dental caries continues to be a major cause of odontogenic pain which drives a patient to seek endodontic intervention. However, notable suppression of postoperative endodontic pain still remains an unresolved conundrum. Aim: To compare the effect of single dose of 100 mg of aceclofenac, 10 mg of ketorolac and a combination of 50 mg tramadol with 75 mg diclofenac, as a pretreatment analgesic for the management of postoperative endodontic pain in patients with symptomatic irreversible pulpitis. Materials and Methods: Thirty emergency patients with moderate to severe pain, diagnosed with symptomatic irreversible pulpitis were randomly allocated (1:1:1) to any of the three groups; aceclofenac, ketorolac, or tramadol + diclofenac. Medications were administered 30 min before beginning of the endodontic treatment. Patients recorded pain intensity on 10 cm visual analog scale (VAS) after treatment, for upto 24 h. Results: At 24 h, mean \u00c2\u00b1 standard deviation (SD) of VAS scores (in cm) for aceclofenac, ketorolac, and tramadol + diclofenac were 3.91 \u00c2\u00b1 0.31, 1.41 \u00c2\u00b1 0.96, and 1.00 \u00c2\u00b1 0.94, respectively. Kruskal-Wallis test showed significant difference among the three groups (P = 0.0000). Conclusion: Single oral dose of 50 mg tramadol with 75 mg diclofenac and 10mg of ketorol as a pretreatment analgesic significantly reduced postoperative endodontic pain in patients with symptomatic irreversible pulpitis when compared to 100 mg of aceclofenac.