Pregabalin as an Effective Adjunct in Postoperative Care following Third Molar Removal

Background: The surgical removal of impacted mandibular third molar is probably the most commonly performed procedure in oral & maxillofacial surgery. This study aimed to evaluate the effectiveness of pregabalin as an adjunct to standard analgesia for managing postoperative pain, facial swelling, and trismus following mandibular third molar extraction.  Methods: A total of 136 patients undergoing bilateral extractions were included. Each patient served as their own control, receiving pregabalin with standard analgesia for one extraction and only standard analgesia for the other. Postoperative pain was assessed using the Visual Analogue Scale (VAS) at various intervals, while facial swelling and interincisal distance (IID) were measured on Days 1, 3, 7, and 14.  Results: VAS scores were higher in the control group; however, it was not statistically significant (P = 0.000) at any time interval. % facial swelling was significantly lower in the test group on postoperative day 1[2.32(1.77- 2.95) test; 2.32 (1.82-3.60) control; P = 0.009] and day 3 [6.67 (5.17-8.44) test; 7.49 (5.77-9.43) control; P = 0.004]. However, no significant differences were seen on postoperative day 7 and day 14. Similarly, no significant differences in mouth opening measurements were found.  Conclusion: Pregabalin is effective as an adjuvant therapy in reducing pain and facial swelling after third molar surgery. However, multicenter, randomized, double- blinded studies are recommended to confirm these findings.