Comparative evaluation of the efficacy of transdermal ketoprofen patch and oral ketoprofen in management of post operative pain after minor periodontal surgery- A randomized controlled trial

Pain has been defined as an unpleasant sensory and emotional experienceassociated with actual or potential tissue damage or described in terms of suchdamage.

Pain felt during minor periodontal procedures are usually unpleasant, dull,throbbing and persistent in nature.

Minor periodontal surgical procedures are invasive procedures in whichsmaller incisions are made with no extensive damage to the gingival tissuesthereby causing lesser chances of infection with a shorter healing period.

Postoperative pain is a predictable event in most cases hence, stepsshould be taken to minimize the pain and discomfort that the patientexperiences after minor periodontal surgical procedures.

Currently local anesthesia and analgesics have made the procedureadmirably painless. Concept of using analgesics such as NSAIDs came from itsmechanism of action at the site of injury and within the central nervous system.NSAIDs also have a direct analgesic effect that is distinct from theirinhibition of prostaglandin formation.

The use of nonsteroidal analgesic has its advantages of adequate paincontrol, but it has its various disadvantages of causing adverse effectsinherent to the medication. These effects include gastric irritations, multipleoral or parenteral analgesic administration, or allergic reactions to the drugsitself. Attempt from the physician’s aspect is to maximize the alleviation ofpain and minimizing the adverse effects associated with the drug to look forother alternatives.

One attractive alternative is the use of a topical therapeutic system,known for its efficacy in various medical fields and offering other distinctadvantages. Objective of topical analgesic therapy is to attain comparableanalgesic effect with fewer adverse effects than oral analgesics. The serum concentrationof the drug achieved with topical analgesics is relatively low, and thussystemic effects and drug-drug interaction is reduced. In addition, bypassingthe first-pass metabolism considerably reduces the total drug dosage needed.

Ketoprofen, a hydrophilic NSAID with physiochemical property, is widelyused both orally and topically for effective pain relief. Various topicalformulations of ketoprofen have been studied, including the patch, gel, andsolution wherein patches were seen to exhibited more control release.

Transdermal patch of ketoprofen was formulated using four formulas usingpolyethylene glycol 400, polyvinylpyrrolidone K-30, and ethyl cellulose as thepolymer. Transdermal patches of ketoprofen have gained popularity as aneffective analgesic due to advantages such as ease of topical application, reducedrisk of dose dumping compared to creams, ointments, and gel forms. It alsooffers advantages like prolonged duration of action, self-administrationcapability and ease of termination thereby improving the patient’s compliance.

This study is first of its kind which will evaluate the efficacy oftransdermal ketoprofen patch in post-operative pain management after minorperiodontal procedures.