Evaluating the Efficacy of Fentanyl Versus Diclofenac Sodium as Transdermal Patches in Controlling Post-operative Pain in Mandibular Third Molar Surgeries: A Prospective Comparative Study

Abstract

Introduction:

Effective dental treatment requires proper technique and post-operative pain management. While NSAIDs like diclofenac and opioids like fentanyl are common, their administration affects efficacy and side effects. Transdermal patches provide sustained drug release and high bioavailability, but limited studies on their use in third molar surgeries highlight the need for further research. This study aimed to compare the efficacy of transdermal fentanyl and diclofenac sodium patches in managing post-operative pain following mandibular third molar trans-alveolar surgeries assessed using Visual Analog Scale (VAS) scores, with evaluations of rescue medication use, discomfort, and overall patient satisfaction at 24, 48, and 72 hours.

Method:

A randomized study (IHEC & IRDC approved) with 60 participants (18-60 years) compared post-extraction pain management. Group A received a single 25 mcg Fentanyl patch for 3 days, while Group B received three 100 mg diclofenac patches (one per day). Rescue paracetamol (650 mg) was provided if needed, and additional patches were advised if required. Patients recorded their responses in an evaluation proforma.

Results:

Pain relief was similar in both groups, with no significant differences over time. Group B (Diclofenac) had less discomfort in the first 24 hours (P = .001, P = .008), while Group A (Fentanyl) initially needed more PCM but required fewer doses later. Patient satisfaction was higher in Group A, with more participants rating their experience as “very good” (P = .009).

Conclusion:

This study found Fentanyl patches (Group A) superior to Diclofenac (Group B) in pain management, lowering medication use, and enhancing patient satisfaction, supporting opioid use for moderate to severe pain specially after 72 hours.