COMPARATIVE ANALGESIC EFFECTS OF SINGLE-DOSE PREOPERATIVE ADMINISTRATION OF PARACETAMOL (ACETAMINOPHEN) 500 mg PLUS CODEINE 30 mg AND IBUPROFEN 400 mg ON PAIN AFTER THIRD MOLAR SURGERY.
J Evid Based Dent Pract
; 21(4): 101611, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34922726
ABSTRACT
BACKGROUND:
Efficacy and rapid onset of postsurgical oral pain relief are critical to improve clinical outcomes and reduce the risk of excessive dosing with analgesic drugs.PURPOSE:
To compare analgesic effects of preoperative administration of paracetamol 500â¯mg plus codeine 30â¯mg in single-tablet and effervescent formulation to ibuprofen 400â¯mg, and placebo in the management of moderate to severe postoperative pain after mandibular third molar surgery. MATERIALS ANDMETHODS:
One hundred twenty healthy outpatients aged 15-29 years undergoing surgical removal of 1 bony impacted mandibular third molar were enrolled in this, single-center, prospective, randomized, triple-blind parallel-group, placebo-controlled, clinical trial. Study participants were randomly assigned to three treatment arms. According to the concealed allocation, each patient 30 minutes before surgery received paracetamol 500â¯mg plus codeine 30â¯mg (group APAP/COD), ibuprofen 400â¯mg (group IBU) or placebo (group PLA). Rescue therapy allowed in the postoperative period was paracetamol 500â¯mg plus codeine 30â¯mg in groups APAP/COD and PLA and ibuprofen 400â¯mg in group IBU. Patients recorded on Numerical Rating Scale-11 (NRS-11) the pain intensity, total number of postoperative-supplement medications and time of the first intake, until 12-hours after surgery and over extra 2 days,RESULTS:
Over postoperative 3 days, patients in the APAP/COD group (2.33 ± 1.99) displayed significantly (P< .001) less pain intensity than IBU (3.43 ± 2.47) and placebo (3.57 ± 2.62) groups. The first-day postoperative pain was significantly (P < .001) higher in group PLA than in groups APAP/COD and IBU, but not between the latter 2 groups. However, at 2 hours postdose, the IBU group displayed average pain intensity lower than APAP/COD group (P> .05). On the next 2 days, pain intensity was significantly (P< .001) lower in group APAP/COD than in groups IBU and PLA but failed to reach statistical significance between groups IBU and PLA. Although the time to the first using rescue therapy was longer (445.88 ± 159.96 minute) in group IBU, compared to groups APAP/COD (392.67 ± 138.90 minutes) and PLA (323.00 ± 143.95 minutes), the number of supplemented tablets was significantly higher in group IBU (2.89 ± 2.13) than in groups APAP/COD (1.24 ± 1.79) (P= .001) and PLA (1.53 ± 1.67) (Pâ¯=â¯.008). No adverse events were registered for all groups.CONCLUSIONS:
Within the limits of the present study, over postoperative 3 days, a statistically significant intensity pain reduction and decreased rescue therapy consumption were recorded in the paracetamol-codeine group than to ibuprofen group. Nevertheless, lower pain intensity at 2 hours postdose and longer time using rescue therapy was found in the ibuprofen group without statistical significance. No adverse events occurred over the studied period.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Ibuprofeno
/
Acetaminofen
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article