Analgesic and anti-inflammatory effects of paracetamol evaluated by bilateral oral surgery

1 In a double-blind crossover study, essentially the same operation was performed on two separate occasions in 24 healthy patients. 2 On one occasion they were given paracetamol (Panadol) 1 g four times daily for 2 d, then 0.5 g four times daily for the next 2 d; on the other, they were given placebo tablets. 3 Several objective and subjective assessments were recorded for a paired comparison of the postoperative courses. 4 Significantly less swelling was measured after the operation when paracetamol was given; on day 3 it averaged 71% of that with placebo. This reduction in postoperative swelling was greater than the reduction previously obtained with ibuprofen and oxyphenbutazone using the same clinical model. 5 With paracetamol, a tendency was noted towards reduced local inflammatory temperature increase and less postoperative bleeding. 6 The results of this clinical trial agree with recent findings in animals studies which show paracetamol to be anti-inflammatory. 7 The pain and preference scores were clearly in favour of paracetamol. Adequate pain relief with paracetamol may require doses as high as 1 g three to four times daily. 8 The results obtained in this model with bilateral oral surgery suggest that in situations in which there are tissue lesions caused by surgery or injury, paracetamol may be preferable to acetylsalicylic acid if swelling and bleeding are to be prevented or reduced.