Dionne, R. A., Campbell, R. A., Cooper, S.A., Hall D. L., Buckingham, B., Suppression of Postoperative Pain by Preoperative Administration of Ibuprofen in Comparison to Placebo, Acetaminophen and Acetaminophen Plus Codeine. J Clin Pharmacology 1983;23:37.

One hundred and seven patients had extraction of impacted third molars with diazepam sedation and local anesthesia, followed for 8 hours postsurgery. Four groups of randomly assigned patients:

• Group 1 got 800 mg ibuprofen 30 minutes prior to surgery then 4 and 8 hours later got 400 mg ibuprofen and placebo capsule.
• Group 2 got acetaminophen 600 mg 30 minutes prior to surgery then 4 and 8 hours later got 600 mg acetaminophen.
• Group 3 got placebo prior to surgery and 600 mg acetaminophen plus 60 mg codeine at 4 and 8 hours after surgery.
• Group 4 got placebo prior to surgery and placebo at 4 and 8 hours postsurgery.

Patients rated pain hourly as none, slight, moderate or severe.

The ibuprofen group had significantly less pain then either of the acetaminophen groups or the placebo group in the early postoperative period as the anesthesia wore off. This was also seen following the second dose at 4 hours (i.e., hours 5 to 8). The overall sum of pain intensity after the second dose also showed the acetaminophen plus codeine gave the same analgesia as acetaminophen alone. The number of patients in each group was small and so caution should be used before making generalizations from this study.

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