A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery

Objectives: This study aimed to determine the number needed to treat (NNT) of ketorolac in comparison to placebo after third molar surgery. Methods: Studies located in PubMed, Scopus, and Web of Science were evaluated with the Cochrane Risk of Bias assessment tool. Data on the onset of analgesia, th...

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Main Authors: Mario Alberto Isiordia-Espinoza, Othoniel Hugo Aragon-Martinez, Nicolás Addiel Serafín-Higuera, Sandra López-Verdín, Eduardo Gómez-Sánchez, Nelly Molina-Frechero, Ronell Bologna-Molina, Juan Manuel Guzmán-Flores, Itzel Joselyn Mora-Falcón
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Clinics and Practice
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Online Access:https://www.mdpi.com/2039-7283/15/4/81
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author Mario Alberto Isiordia-Espinoza
Othoniel Hugo Aragon-Martinez
Nicolás Addiel Serafín-Higuera
Sandra López-Verdín
Eduardo Gómez-Sánchez
Nelly Molina-Frechero
Ronell Bologna-Molina
Juan Manuel Guzmán-Flores
Itzel Joselyn Mora-Falcón
author_facet Mario Alberto Isiordia-Espinoza
Othoniel Hugo Aragon-Martinez
Nicolás Addiel Serafín-Higuera
Sandra López-Verdín
Eduardo Gómez-Sánchez
Nelly Molina-Frechero
Ronell Bologna-Molina
Juan Manuel Guzmán-Flores
Itzel Joselyn Mora-Falcón
author_sort Mario Alberto Isiordia-Espinoza
collection DOAJ
description Objectives: This study aimed to determine the number needed to treat (NNT) of ketorolac in comparison to placebo after third molar surgery. Methods: Studies located in PubMed, Scopus, and Web of Science were evaluated with the Cochrane Risk of Bias assessment tool. Data on the onset of analgesia, the number of patients requiring rescue medication, the global or general evaluation of the study medication, and adverse effects were extracted. Data analysis was performed using Review Manager 5.3 software for Windows. Results: The qualitative assessment of the included studies showed that ketorolac was more effective than a placebo and the quantitative evaluation on the onset of analgesia (NNT = 1.6 (95%CIs = 1.4, 1.9), n = 301), the number of patients who took rescue analgesics (NNT = 3.6 (95%CIs = 2.8 to 4.9), n = 563), and the global evaluation of the treatments (NNT = 1.7 (95%CIs = 1.5 to 1.9), n = 475) showed estimates of analgesic efficacy with a statistical difference in favor of ketorolac when compared with a placebo. No statistical difference was observed in adverse effects between ketorolac and placebo (n = 739). Conclusions: There is scientific evidence of moderate quality that allows estimators of the analgesic efficacy of ketorolac to be calculated, which will significantly help the clinician who performs pharmacological treatment after third molar surgery.
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spelling doaj-art-5dc89e543c994ba798e4c4882f8720892025-08-20T02:24:45ZengMDPI AGClinics and Practice2039-72832025-04-011548110.3390/clinpract15040081A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar SurgeryMario Alberto Isiordia-Espinoza0Othoniel Hugo Aragon-Martinez1Nicolás Addiel Serafín-Higuera2Sandra López-Verdín3Eduardo Gómez-Sánchez4Nelly Molina-Frechero5Ronell Bologna-Molina6Juan Manuel Guzmán-Flores7Itzel Joselyn Mora-Falcón8División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, MexicoDepartamento de Farmacología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78290, MexicoFacultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali 21040, MexicoCentro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44100, MexicoCentro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44100, MexicoDepartamento de Atención a la Salud, Universidad Autónoma Metropolitana-Unidad Xochimilco, Ciudad de México 14387, MexicoÁrea de Patología Molecular, Facultad de Odontología, Universidad de la República de Uruguay, Montevideo 11200, UruguayDivisión de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, MexicoDivisión de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, MexicoObjectives: This study aimed to determine the number needed to treat (NNT) of ketorolac in comparison to placebo after third molar surgery. Methods: Studies located in PubMed, Scopus, and Web of Science were evaluated with the Cochrane Risk of Bias assessment tool. Data on the onset of analgesia, the number of patients requiring rescue medication, the global or general evaluation of the study medication, and adverse effects were extracted. Data analysis was performed using Review Manager 5.3 software for Windows. Results: The qualitative assessment of the included studies showed that ketorolac was more effective than a placebo and the quantitative evaluation on the onset of analgesia (NNT = 1.6 (95%CIs = 1.4, 1.9), n = 301), the number of patients who took rescue analgesics (NNT = 3.6 (95%CIs = 2.8 to 4.9), n = 563), and the global evaluation of the treatments (NNT = 1.7 (95%CIs = 1.5 to 1.9), n = 475) showed estimates of analgesic efficacy with a statistical difference in favor of ketorolac when compared with a placebo. No statistical difference was observed in adverse effects between ketorolac and placebo (n = 739). Conclusions: There is scientific evidence of moderate quality that allows estimators of the analgesic efficacy of ketorolac to be calculated, which will significantly help the clinician who performs pharmacological treatment after third molar surgery.https://www.mdpi.com/2039-7283/15/4/81ketorolacplacebothird molar surgerypostoperative dental painmeta-analysis
spellingShingle Mario Alberto Isiordia-Espinoza
Othoniel Hugo Aragon-Martinez
Nicolás Addiel Serafín-Higuera
Sandra López-Verdín
Eduardo Gómez-Sánchez
Nelly Molina-Frechero
Ronell Bologna-Molina
Juan Manuel Guzmán-Flores
Itzel Joselyn Mora-Falcón
A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
Clinics and Practice
ketorolac
placebo
third molar surgery
postoperative dental pain
meta-analysis
title A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
title_full A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
title_fullStr A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
title_full_unstemmed A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
title_short A Quantitative Systematic Review on the Analgesic Efficacy and Adverse Effects of Ketorolac in Third Molar Surgery
title_sort quantitative systematic review on the analgesic efficacy and adverse effects of ketorolac in third molar surgery
topic ketorolac
placebo
third molar surgery
postoperative dental pain
meta-analysis
url https://www.mdpi.com/2039-7283/15/4/81
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