ABSTRACT
Background
Postoperative pain, swelling and trismus are the most common outcome after third molar surgery. Many methods have been tried to improve postoperative comfort after surgery. Ketamine is a phencyclidine derivative that induces a state of dissociative anesthesia. It is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist and has a distinct suppression effect on central nervous system (CNS) sensitization. Ketamine in a subanesthetic dose is set to produce analgesic and anti-inflammatory effect.
Materials and methods
Sixty patients, between the age group of 18 and 38 years, undergoing the extraction of impacted mandibular third molar, reporting to the department of oral and maxillofacial surgery were included in the study.
Patients were divided randomly into two groups: local anesthetic alone (LAA) and local anesthetic and ketamine (LAK).
Statistical analysis
Statistical analysis was performed using the Mann-Whitney U/unpaired—t-test and Wilcoxon signedrank test.
Result
There was a significant difference in mouth opening in the LAA and LAK group in the immediate postoperative period. There was a significant difference between the two groups after 1 hour (LAA: 2.37; LAK: 1.40), and 4 hours (LAA: 2.37; LAK: 1.40).
There was a significant difference in terms of facial swelling in the immediate postoperative period and day 1 between the LAA and LAK group.
Clinical significance
Use of subanesthetic dose of ketamine is not only safe but also valuable in reducing patient morbidity after third molar surgery.
Conclusion
Combination of a local anesthetic and subanesthetic dose of ketamine during surgical extraction of third molars provides good postoperative analgesia with less swelling and significantly less trismus.
How to cite this article
Kumar A, Kale TP. A Comparative Study between the Effect of Combined Local Anesthetic and Low-dose Ketamine with Local Anesthetic on Postoperative Complications after Impacted Third Molar Surgery. J Contemp Dent Pract 2015;16(12):957-962.
Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study