COMPARISON OF CELECOXIB VERSUS ACETAMINOPHEN AS PRE-EMPTIVE ANALGESICS FOR MANAGEMENT OF POST OPERATIVE PAIN AFTER IMPACTED MANDIBULAR THIRD MOLAR SURGERY

Abstract

Background: Pain following impacted mandibular third molar surgery is a common postoperative complaint that may negatively affect patients' comfort and quality of life. Administration of analgesics before surgical trauma has been proposed as an effective strategy to reduce postoperative pain and analgesic requirements. Objective: To compare the effectiveness of oral celecoxib and oral acetaminophen administered as pre-emptive analgesics for postoperative pain control after impacted mandibular third molar surgery in terms of pain intensity and rescue analgesic consumption. Methods: A prospective randomized controlled trial was conducted in the Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry (AFID), Rawalpindi, from June 2025 to December 2025. Seventy patients aged 17–50 years requiring surgical removal of an impacted mandibular third molar were randomly allocated into two equal groups. Group A received oral acetaminophen 500 mg, whereas Group B received oral celecoxib 200 mg, both administered 30 minutes before surgery. Postoperative pain was assessed using the Visual Analogue Scale (VAS) at 4, 6, and 8 hours after surgery. Ibuprofen tablets consumed during the first 24 hours served as the rescue analgesic outcome. Results: Patients receiving celecoxib demonstrated significantly lower mean postoperative pain scores at 4, 6, and 8 hours than those receiving acetaminophen (p<0.0001). Mean rescue analgesic consumption during the first 24 hours was also significantly lower in the celecoxib group (0.97 ± 0.66 tablets) compared with the acetaminophen group (2.40 ± 0.88 tablets) (p<0.001). Conclusion: Pre-emptive oral celecoxib was more effective than oral acetaminophen in reducing postoperative pain and decreasing rescue analgesic requirements following impacted mandibular third molar surgery.