Comparison of Bromelain and Diclofenac in the Management of Postoperative Pain and Quality of Life Following Root Canal Therapy: A Randomized Controlled Trial.

Aim This study aimed to compare the analgesic efficacy and adverse effects of oral bromelain and diclofenac in relieving postoperative pain and improving postoperative quality of life in patients with irreversible pulpitis in mandibular first molars after root canal therapy. Materials and methods A simple randomized double-blinded clinical trial was carried out. One hundred patients with symptomatic pulpitis requiring root canal therapy of mandibular first permanent molars were randomly divided into two groups after obtaining informed consent. After access opening, preparation of the root canal and temporization, Group I (n=50) patients received oral bromelain 200 mg and Group II (n=50) received oral diclofenac sodium 50 mg, respectively. The patients were asked to rate their pain on a visual analog pain intensity scale (VAS) and rate their quality of life using the postoperative quality of life (POQoL) questionnaire after 6, 12, 24, 48, and 72 hours. Results Bromelain and diclofenac were equally effective for postoperative analgesia, but diclofenac showed immediate pain relief and improved quality of life at 6 hours. After 12 hours bromelain showed similar effects in managing pain and postoperative quality of life with less adverse effects. Conclusions When compared to diclofenac, bromelain has the same analgesic efficacy after 12 hours but a lower risk of adverse effects in patients receiving root canal therapy for postoperative pain. Diclofenac is more effective in immediate postoperative pain relief and improvement in quality of life for patients with moderate to severe pain.