Transdermal diclofenac patch for pain control after periodontal osseous surgery: A comparative clinical trial.

Dr. Huda Hussain; Prof. Suhail Majid Jan

Volume : VIII, Issue : VI, June - 2019

Transdermal diclofenac patch for pain control after periodontal osseous surgery: A comparative clinical trial.

Dr. Huda Hussain, Prof. Suhail Majid Jan

Abstract :

Contemporary standards of patient care entail a complete painless perioperative experience. While periodontal surgery does not result in more discomfort than other dental procedures, a significant inflammatory reaction can be expected when osseous reshaping or resection is involved. This study compares the pain control efficacy of transdermal route with the conventional oral route of the most commonly implicated NSAID, diclofenac. Twenty chronic generalized periodontitis patients were included in a split mouth study design. After periodontal surgery requiring osseous reshaping was performed in one quadrant, twice daily dose of 50 mg diclofenac was prescribed for 3 days. Two weeks later, surgery was performed in the other quadrant, and a 100 mg transdermal diclofenac patch was placed at hairless skin, which was replaced every 24 hours for 3 days. Patients were asked to record the pain intensity and pain relief immediately after surgery, at 2 hrs, 4 hrs, 8 hrs, 12 hrs, 24 hrs, 48 hrs and 72 hrs postoperatively, using a four point scale. Paired t–test was used to assess the responses. A significantly lesser pain intensity and better pain relief was noted with oral diclofenac as compared to the transdermal route during the initial 12 hours after surgery. However, thereafter, the difference between the two treatments was statistically non–significant, with progressive decline in pain intensity over the 3 postoperative days. It was concluded that though the transdermal route resulted in lesser adverse effects and response fluctuations, for osseous periodontal surgery, oral diclofenac results in better pain control initially. 100 mg Transdermal diclofenac, if used, should be in a higher concentration or supplemented with other analgesics during the early postoperative period