Analgesic efficacy after single and repeated doses of codeine and acetaminophen

A double-blind randomized analgesic trial was carried out in patients suffering from pain after removal of a third molar tooth. In a two-dose regimen, 108 patients received either 60 mg codeine, 500 mg acetaminophen, or 1000 mg acetaminophen. On the day of surgery, the patients assessed their pain intensity hourly on a visual analog scale. The evaluation was carried out during the 10-hour period after first medication. The best pain reducing effects were achieved with 1000 mg acetaminophen. Both the category and position of each tooth were examined in relation to pain intensity; however, the statistical analysis did not reveal any significant correlation. In all treatment groups, the efficacy of the second dose was superior to that of the first, and the most pronounced difference was obtained in patients taking codeine, who increased their pain reduction from 20 to 60 per cent. Clinical comparisons including codeine may therefore be better carried out in a repeated-dose regimen.