Pain relief after dental impaction surgery using ketorolac, hydrocodone plus acetaminophen, or placebo

In a double-blind, placebo-controlled study, 207 patients with moderate pain after surgical removal of impacted third molars were randomly assigned to receive a single oral dose of 10 mg of ketorolac tromethamine, 10 mg of hydrocodone plus 1000 mg of acetaminophen, or placebo. Analgesic effect as assessed by summed pain intensity difference at 3 and 6 hours was significantly (P < or = 0.01) greater after ketorolac than after hydrocodone/acetaminophen. Total pain relief at 3 and 6 hours was significantly (P < 0.026) greater after ketorolac than after hydrocodone/acetaminophen or placebo. Patients taking hydrocodone/acetaminophen remedicated significantly (P = 0.027) sooner than those taking ketorolac. In this single-dose study, adverse events were reported more frequently by patients taking hydrocodone/acetaminophen than with ketorolac or placebo. It is concluded that, in this pain model, 10 mg of ketorolac affords better pain relief with fewer side effects than hydrocodone/acetaminophen.