Background: Pain and trismus are common complications that significantly impair quality of life after mandibular third molar surgery. This study investigated the efficacy of only one preoperative dose of oral tizanidine, a centrally acting muscle relaxant having analgesic properties, in reducing these outcomes. Methods: Forty patients who needed surgical removal of bilateral impacted mandibular third molars were selected for a split-mouth, triple-blind, randomized clinical trial. Each patient was randomly assigned to receive 4 mg tizanidine or a placebo 1 h before surgery on one side. In the other surgery, the contralateral side was treated alternatively. The Visual Analog Scale (VAS) was used for pain assessment, and trismus was measured by maximum mouth opening (MMO) in millimeters at Days 1, 3, and 7 post-surgery. Paired t -test and repeated measures analysis of variance were used to analyze data. Results: Tizanidine group had significantly lower mean VAS pain scores compared to the placebo group on the first postoperative day (3.30 ± 0.87 vs 5.25 ± 1.02; p < 0.001). Both groups experienced a decrease in pain scores over time, though the differences in Days 3 and 7 did not reach statistical significance. Nonetheless, the tizanidine group had significantly greater MMO (less trismus) than the control group at all postoperative time points ( p < 0.001 for all). Conclusions: A single dose of preoperative oral tizanidine provides a useful supplementary tool to diminish immediate postoperative pain and relieve trismus after surgical removal of mandibular third molars. Tizanidine can be included as an adjunct in multimodal techniques to improve patient comfort and recovery following oral surgeries.
Golkar et al. (Sun,) studied this question.