Is Paracetamol Better than Diclofenac Sodium in Management of Postoperative Pain and Edema Following Major Maxillofacial Surgeries?

Introduction: Paracetamol is an optimal non-opioid analgesic and holds considerable advantages over NSAIDs in managing post-operative pain. Literature to date doesn't provide substantial documentation of it's efficacy and safety in major oral and maxillofacial surgeries. The study is designed to compare the effectiveness of intravenous paracetamol with diclofenac sodium for controlling post-operative pain and edema in major oral and maxillofacial surgeries. Method: The double-blind randomised prospective study includes 140 healthy patients with ASA grades I and II. Patients were divided into Group A (1gm paracetamol) and B (75 mg diclofenac sodium), 70 patients each, undergoing similar surgical procedures. VAS and VRS were assessed for pain and thread method for measuring swelling. Mouth opening in space infections was measured with calliper and scale. Results: Independent samples t-test and chi-square test showed longer pain-free interval, more interval between first and second dose, lesser number of doses required in Group A than Group B (p-value < 0.05). Independent samples t-test and Mann-Whitney test showed faster resolution of swelling in Group A (p-value < 0.05). Independent samples t-test showed lesser time taken for resolution of trismus in space infections in Group A (p-value < 0.05). Discussion: Paracetamol 1 g was found to be an effective analgesic with less adverse effects. It is superior non-opioid analgesic in reducing the intensity of post-operative pain and swelling, also requires less number of doses than diclofenac sodium in major surgeries. Patients treated with paracetamol had better quality of life during post-operative period.

A rare case report of mucinous cystadenoma with immunohistochemical analysis and review of literature.

Cystadenomas are rare salivary gland tumours characterised by prominent epithelium-lined papillary projections into the cystic spaces. A 37 year-old female, presented with a swelling on the right side of the hard palate. Clinically, the swelling was soft, fluctuant, sessile and non-tender measuring 2.5 × 2 cm in diameter. Excisional biopsy was performed. The histopathological and immunohistochemical features were characteristic of mucinous cystadenoma. There has been no recurrence over a 2-year follow up period. The article highlights its clinical, histopathological, immunohistochemical features and differential diagnosis along with review of literature. Cystadenoma of the palate is rare, papillary variety being more common than mucinous with very few cases reported in literature.