ROLE OF PREEMPTIVE NALBUPHINE IN REDUCING THE USE OF POSTOPERATIVE ANALGESICS FOR PAIN AND TRISMUS AFTER SURGICAL EXTRACTION OF IMPACTED MANDIBULAR THIRD MOLAR

Background: To underscore the significance of risk mitigation strategies associated with the surgical extraction of impacted mandibular third molar, a comprehensive understanding of postoperative complications is essential. Such primary complications include the possibilities of postoperative pain, trismus, infection, nerve injury, excessive hemorrhage, delayed healing and inadvertent damage to neighboring structures. This study investigates the impact of preemptive intravenous nalbuphine administration on postoperative pain and trismus management following surgical extraction of impacted mandibular third molars. Methods: A total of 310 patients were divided into two groups, with Group I (n=156) receiving nalbuphine and Group II (n=154) receiving a placebo. Postoperative pain scores (on visual analog scale), analgesic usage, and maximum mouth opening (MMO) were evaluated. Results: The patients aged 15-40 year in both groups, with mean = 27.2±7.0 and 28.1±8.3 years for Group I and II, respectively (p>0.05). The mean postoperative pain in Group II was significantly higher (p<0.0001) than Group I, with pain score restricted to 2–6 in group I, compared to 2–10 in Group II. Patients in Group II consumed the postoperative analgesics for significantly longer duration (p<0.0001) than patients in Group I. The MMO data showed that the number of patients with mouth opening less than 30 cm was significantly smaller (p<0.0001) in Group I as compared to Group II (i.e., 42 versus 114). Conclusions: These results underscore the therapeutic potential of preemptive nalbuphine in enhancing patient comfort and recovery after impacted mandibular third molar extraction, providing a valuable framework for optimizing patient outcomes.