Aims: To evaluate the comparison of analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery.

Methodology: Hundred patients in the age group of 20–40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups. All the patients underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary parameters: pain intensity being measured hourly by Wong Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient’s global assessment.

Results: Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia.

Conclusion: The result of the present study shows that preoperative IV ketorolac 30mg is more effective than tramadol 50mg for postoperative pain following third molar surgery.