Additive analgesia without opioid side effects

Postoperative pain control is often inadequate because of insufficient pain relief or unacceptable side effects. Nonsteroidal antiinflammatory drugs (NSAIDs) are very efficacious for pain of dental origin, but their ceiling of efficacy does not result in greater peak analgesia if the dose is raised beyond recommended limits. Switching to an opioid combined with acetaminophen or aspirin does not result in greater analgesia, but increases the incidence of side effects such as drowsiness and nausea. Combining NSAIDs with opioids has been largely unsuccessful and still results in opioid side effects. The combination of NSAIDs with acetaminophen holds promise for greater analgesia than either drug alone, but without the increased side effects associated with opioids in ambulatory dental patients.