comparison of single versus multimodel analgesia in ablative maxillofacial surgical procedures

Objectives of this study was to evaluate the analgesic effect of single vs multimodal analgesics in postoperative pain in ablative maxillofacial surgery and to investigate whether prophylactic treatment with multimodal nociceptive blockade will delay the onset of postoperative pain, decrease analgesic requirement, speed recovery time and facilitate early discharge in this surgical group. This experimental comparative study was conducted in Maxillofacial Operation Theatre of Nishter Institute of Dentistry, Multan during the period from August 2013 to Feb 2014 equal groups of 30 each using non probability convenience sampling technique. In Group A patients an intramuscular injection of Ketorolac 0.5mg/kg was given 45 min before induction of anaesthesia preoperatively. In group B patients intramuscular injection of 0.5mg/kg ketorolac + 2mg/kg body weight of Tramadol [IM] was given 45 min before induction of anaesthesia preoperatively + local infiltratration of 0.5% injection bupivacaine was done 10 min before giving incision. In Group A patients, 17 patients [56.6%] had mild pain, 6 patients [20%] had moderate, 5 patients [16%] had severe and 2 patients [6.66%] had no pain. While in group B who received multimodal analgesia, the degree of postoperative pain was greater than in the group A in which 15 patients [50%] had mild pain, 2 patients [6%] had moderate pain and 13 patients [43.3%] had no pain. In group B, no patient suffered from severe pain. It was concluded that multimodal analgesia showed greater advantage over single analgesia in patients undergoing ablative maxillofacial surgical procedures