biostudies-literatureUnknown32Kim SH<h4>Background</h4>Several analgesics have been applied under various protocols to control the moderate-to-severe postoperative pain caused by the surgical extraction of an impacted mandibular third molar. However, a consensus on optimal pain management while minimizing side effects is yet to be reached.<h4>Methods</h4>This multi-center, prospective, double-blind, randomized controlled trial aims to evaluate the efficacy and safety of sequential multimodal analgesia combined with postoperative zaltoprofen along with multiple preemptive analgesics. A total of 80 participants with bilateral impacted mandibular third molar from two hospitals were randomized into two groups. Two surgical extractions were performed at one-month intervals, and in a crossover design, celecoxib or tramadol/acetaminophen was administered before one extraction and placebo before the other extraction. Following extraction, all subjects took zaltoprofen for 5 days. The outcome measures included pain at specific times, time and intensity of the first pain onset after extraction, need of rescue drugs, and occurrence and frequency of side effects.<h4>Conclusions</h4>This ongoing clinical trial was designed to provide evidence regarding a new protocol for effective postoperative pain management of a commonly performed surgical extraction. The results of this study will provide guidance to clinicians regarding the timing and combination of oral analgesics in various oral surgeries performed under local anesthesia.<h4>Trial registration</h4>KCT0005450, registered on October 7, 2020.Contemporary clinical trials communications101078https://www.ebi.ac.uk/biostudies/studies/S-EPMC9905937biostudies-literatureApplication of sequential multimodal analgesia before and after impacted mandibular third molar extraction: Protocol for a randomized controlled trial.PMC9905937Kim SKim SHSong MKKang JYKim YSfalseApplication of sequential multimodal analgesia before and after impacted mandibular third molar extraction: Protocol for a randomized controlled trial.<h4>Background</h4>Several analgesics have been applied under various protocols to control the moderate-to-severe postoperative pain caused by the surgical extraction of an impacted mandibular third molar. However, a consensus on optimal pain management while minimizing side effects is yet to be reached.<h4>Methods</h4>This multi-center, prospective, double-blind, randomized controlled trial aims to evaluate the efficacy and safety of sequential multimodal analgesia combined with postoperative zaltoprofen along with multiple preemptive analgesics. A total of 80 participants with bilateral impacted mandibular third molar from two hospitals were randomized into two groups. Two surgical extractions were performed at one-month intervals, and in a crossover design, celecoxib or tramadol/acetaminophen was administered before one extraction and placebo before the other extraction. Following extraction, all subjects took zaltoprofen for 5 days. The outcome measures included pain at specific times, time and intensity of the first pain onset after extraction, need of rescue drugs, and occurrence and frequency of side effects.<h4>Conclusions</h4>This ongoing clinical trial was designed to provide evidence regarding a new protocol for effective postoperative pain management of a commonly performed surgical extraction. The results of this study will provide guidance to clinicians regarding the timing and combination of oral analgesics in various oral surgeries performed under local anesthesia.<h4>Trial registration</h4>KCT0005450, registered on October 7, 2020.2023-01-01T00:00:00Z2023 Apr2025-04-18T21:17:07.627Z2025-04-07T09:16:38.784ZS-EPMC99059373676212010.1016/j.conctc.2023.101078