A randomized, crossover, double-blind, controlled trial depicted that using locally applied Diclofenac after mandibular third molar surgery can serve as a substitute for postoperative pain relief, delivering a pain-free experience within six hours. The researchers aimed to evaluate the effect of applying Diclofenac locally on postoperative pain, complications, and adverse effects.

In total, 20 patients who needed symmetrical bilateral impacted mandibular third molars removed in two sessions were included in the study. The 40 mandibular third molars were randomized into 2 groups. The Diclofenac group received 0.1% w/v Diclofenac sodium, while the control group was administered phosphate-buffered saline (PBS).

With the utilization of visual analogue scale (VAS), the level of pain was evaluated following the surgery. Documentation of various aspects of pain management was done, including the time of initial pain onset, the time at which the first rescue medication was needed, pain levels at 6 and 24 hours following the procedure, and the total count of analgesics taken.

Postoperative trismus and swelling were assessed on the 2nd and 7th days after the surgery. Any between-group disparities in continuous outcomes were examined utilizing either the Wilcoxon signed-rank test or the paired t-test. In the Diclofenac group, the VAS scores were notably decreased both at the time of initial pain onset and six hours following the surgical procedure.

Furthermore, the Diclofenac group experienced a significantly delayed onset of pain in comparison with the control group. It's worth noting that 2 individuals in the Diclofenac group reported experiencing mild symptoms of dizziness and nausea. Therefore, 0.1% Diclofenac applied locally provides pain relief within 6 hours after surgery, with few side effects.