Attenuation of C-Reactive Protein Increases After Exodontia by Tramadol and Ibuprofen

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Attenuation of C-Reactive Protein Increases After Exodontia by Tramadol and Ibuprofen
Anesthesia Progress
Volume 53, Issue 3 (Fall 2006)
Eman A. El-Sharrawy, MBBCh, MSc, MD*, Ibrahim E. El-Hakim, BDS, MDS, PhD‹, Elham Sameeh, BDS, MDS‹

* Department of Oral and Maxillofacial Surgery, Tanta University, Cairo, Egypt
‹ Department of Oral and Maxillofacial Surgery, Ain Shams University, Cairo, Egypt

The anti-inflammatory effects of ibuprofen and tramadol were investigated by measuring C-reactive protein concentrations after removal of an impacted lower third molar. Forty-five American Society of Anesthesiologists Class I patients were randomly categorized into 3 equal groups according to postoperative analgesic medication. The first group received tramadol (100 mg every 8 hours), the second group received ibuprofen (400 mg every 8 hours), and the last group received half doses of both drugs in combination (50 mg tramadol every 8 hours and 200 mg ibuprofen every 8 hours). C-reactive protein was measured before surgery to exclude the presence of any preexisting inflammatory condition that might interfere with the study. C-reactive protein was also determined immediately after surgery and 72 hours postoperatively. At 72 hours, C-reactive protein had increased over postsurgery baseline by 123% in the tramadol group (P < .001), 84% in the ibuprofen group (P < .001), and only 37% in the combined analgesic group (P = .078). These results suggest that tramadol may produce supra-additive anti-inflammatory effects with ibuprofen after third-molar extractions.

Keywords: C-reactive protein, Ibuprofen, Tramadol, Dentistry, Oral surgery

Received: September 24, 2004; Accepted: June 12, 2006

DOI: 10.2344/0003-3006(2006)53[78:AOCPIA]2.0.CO;2

Address correspondence to Dr Eman A. El-Sharrawy, c/o Eltagamo Elkhames, PO Box 138, Code 11835, New Cairo City, Egypt; elsharrawy@hotmail.com.

© 2007 The American Dental Society of Anesthesiology