Related Experiment Video
Updated: Mar 3, 2026

Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery
Published on: June 23, 2023
Analgesic efficacy and adverse effects of paracetamol-codeine combination in third molar surgery: a meta-analytic
Alessio Rosa1, Michele Miranda2, Paolo Barnaba2
1Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy - alessio.rosa.21@alumni.uniroma2.eu.
Introduction:
This systematic review and meta-analysis aimed to assess the analgesic efficacy and adverse event profile of paracetamol combined with codeine for managing postoperative pain following third molar surgery.
Evidence Acquisition:
A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library to identify randomized controlled trials comparing paracetamol + codeine with placebo or other analgesics. Data on pain reduction, rescue medication use, and adverse effects were extracted and pooled using a random-effects model. Odds ratios (OR) and numbers needed to treat (NNT) or harm (NNH) were calculated.
Evidence Synthesis:
Six RCTs involving 582 patients met inclusion criteria. The paracetamol-codeine combination significantly reduced postoperative pain and delayed the need for rescue medication (OR=0.45, 95% CI 0.30-0.68). However, adverse events were common, with drowsiness (25%, NNH=7), nausea (18%, NNH=11), and dizziness (12%, NNH=15) being the most frequently reported.
Conclusions:
Paracetamol + codeine provides effective postoperative analgesia for third molar surgery, especially in patients contraindicated for NSAIDs. Clinicians should consider the increased risk of sedation and gastrointestinal symptoms when prescribing this combination, and educate patients accordingly.
Related Concept Videos
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Analgesia and Pain Management
Opioid Analgesics: Morphine and Other Natural Cogeners
Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Combined Effects of Drugs: Synergism
Such synergistic combinations...
