Comparison of efficacy and safety of bromelain with diclofenac sodium in the management of postoperative pain and swelling following mandibular third molar surgery

Abstract

Aim: The present study aimed to evaluate and compare the efficacy and safety of oral bromelain, a natural enzyme complex with oral diclofenac sodium in managing pain and swelling after mandibular third molar surgery. Materials and methods: A total of 40 patients were randomly divided into two groups, the bromelain group (n = 20) and the diclofenac sodium group (n = 20). Patients received either bromelain, 500 mg twice daily or diclofenac sodium, 50 mg thrice daily for five days after the surgical extraction of impacted third molars. Swelling and trismus were evaluated pre-operatively (day0) and on postoperative days 1, 2, and 7, pain on postoperative days 1, 2, and 7,also, the need for rescue medication and adverse effects were evaluated in both groups. Results: There was no difference between the bromelain and diclofenac groups in VAS pain scores (day1 = 35.1 vs 33.4, p = 0.829; day2 = 22 vs 22.4, p = 0.694; day7 = 13 vs 14.3, p = 0.678). There was no difference between the groups in swelling (day0 = 270.8 vs 266.5, p = 0.256; day1 = 279.2 vs 272.8, p = 0.167; day2 = 277.3 vs 271.4, p = 0.151; day7 = 269.2 vs 266.1, p = 0.440), trismus (day0 = 50.5 vs 48.9, p = 0.542; day1 = 29.6 vs 31.7, p = 0.839; day2 = 31.7 vs 32.6, p = 0.882; day7 = 41.1 vs 37.6, p = 0.273) and the number of rescue medications (1.6vs1.9, p = 0.956). Patients in both the groups did not report any severe or serious adverse effects. Conclusions: Bromelain was comparable to diclofenac in the management of postoperative pain, swelling and trismus following impacted mandibular third molar surgery.

Keywords

• Bromelain
• Impacted mandibular third molars
• Pain
• Swelling
• Trismus
• Diclofenac