Paracetamol/codeine in relieving pain following removal of impacted mandibular third molars

A double-blind clinical study of analgesic drugs was conducted involving 47 healthy adults requiring removal of 90 bony impacted mandibular third molars. The analgesic effect of paracetamol plus codeine (P + C) 350 + 20 mg was compared to that of acetylsalicylic acid (ASA) 500 mg and placebo. A standardized surgical procedure under local anesthesia was used. Insufficient analgesic effect was noted in 16% of the ASA group and in 69% of the placebo group but in none in the P+C group. On the first postoperative day, patients given P+C suffered less pain compared with those given ASA (P less than 0.01). No relationship could be demonstrated between the type of impaction and intensity of pain. Trismus, however, was found to be associated with difficulty of extirpation. Drowsiness and an increased sleeping tendency were the main side effects found in the P+C group. The incidence of secondary hemorrhage was high in the ASA group, compared with the P+C group a significance of 0.01 less than P less than 0.05 was found on various postoperative days. Registration of swelling revealed less postoperative edema in the P+C group than in the ASA group (0.01less thanPless than0.05). The main conclusion from this study is that the analgesic effect of P+C orally administered after a specific oral surgical procedure is superior to ASA and placebo. P+C also appears to have a more marked antiphologistic effect than ASA.