Comparison of Diclofenac Transdermal Patch Against Oral Diclofenac for Pain Control Following Removal of Mandibular Impacted Third Molars: A Systematic Review

Abstract

Background: Diclofenac sodium is the most prescribed NSAID for postoperative pain management after third molar surgery. It can be administered through various routes. A transdermal patch, one of the newer routes to administer drugs, has fewer adverse effects and better patient compliance. Aim: To assess the effectiveness of a diclofenac transdermal patch against oral diclofenac for postoperative pain management after third molar surgery. Methods: This literature study used PubMed, Elsevier science direct, Wiley online library, Ovid Medline, Cochrane, Prospero, and CINAHL using MeSH terms- diclofenac sodium, transdermal patch, third molar surgery. Of the total 197 articles screened, 113 were full-text articles assessed for eligibility, and 5 were taken for the qualitative analysis. This search was reported according to the PRISMA guidelines. In addition, five randomized controlled trials were included in the review process. Results: The transdermal patch was compared with the oral group in all the studies, and the transdermal patch showed statistically significant results compared to the oral route. No Meta-analysis was performed due to clinical heterogeneity and differences in data reporting among the included studies. Conclusion: Transdermal patch was effective in improving postoperative pain and equally effective in the oral group and had lower adverse effects and better patient compliance.