Comparative efficacy of soluble aspirin and aspirin tablets in postoperative dental pain

Abstract

The efficacy of single doses (1.2 g) of soluble aspirin and aspirin tablets was determined in a randomised, placebo-controlled, double-blind, parallel study in 90 patients (45 females) with postoperative pain after removal of impacted lower third molars. Also investigated was the relationship between plasma aspirin esterase activity and overall pain scores after both aspirin preparations. Patients reported significantly less pain (p less than 0.001) after treatment with aspirin than after treatment with placebo. However, patients receiving soluble aspirin reported both an earlier onset and a longer duration of pain relief than those who received aspirin tablets. A significant correlation was observed between plasma aspirin esterase activity and overall pain scores after both soluble aspirin (r = 0.57, p less than 0.01) and aspirin tablets (r = 0.51, p less than 0.02). It is concluded that soluble aspirin is the preferred aspirin formulation for treating postoperative pain after third molar surgery and that plasma aspirin esterase activity is determinant of a patient's analgesic response to aspirin in postoperative dental pain.

An investigation into the comparative efficacy of soluble aspirin and solid paracetamol in postoperative pain after third molar surgery

“…These include formulation, dose and plasma concentration of acetylsalicylate. [2][3][4][5] The latter appears to be determined by plasma aspirin esterase activity. By contrast, there is limited information on the efficacy of paracetamol in postoperative dental pain.…”

An evaluation of buffered aspirin and aspirin tablets in postoperative pain after third molar surgery.

“…In previous singledose studies, we have shown that soluble aspirin provided an earlier onset and more prolonged analgesia than the corresponding dose of aspirin tablets in patients with postoperative pain after third molar surgery (Holland et al, 1988;Seymour et al, 1986). Differences in efficacy were attributed to the earlier and greater peak concentrations of ASA after soluble aspirin than after tablets (Levy, 1965;Rance et al, 1975).…”

“…Aspirin esterase activity appears to be an important determinant of the plasma concentrations of ASA and the drug's efficacy in postoperative dental pain (Seymour et al, 1984a(Seymour et al, , 1986. The significant correlation between AUEC(0,300) and aspirin esterase activity continues to support this finding.…”

“…In a series of single dose studies, we have shown that aspirin-induced analgesia in postoperative dental pain is related to dose and formulation (Seymour & Rawlins, 1982;Seymour et al, 1986). On a dose per dose basis, soluble aspirin provided an earlier onset of analgesia than aspirin tablets in the immediate postoperative period after third molar surgery (Holland et al, 1988).…”

An evaluation of different doses of soluble aspirin and aspirin tablets in postoperative dental pain.

“…Aspirin (acetylsalicylic acid, ASA) has been extensively evaluated in postoperative pain after third molar surgery (Cooper & Beaver, 1976;Henrikson et al, 1979;von Graffenried et al, 1980;Skjelbred, 1984), and a previous study (Seymour & Rawlins, 1982) demonstrated that 1200 mg soluble aspirin was more efficacious than 600 mg. Recently, it has also been shown that a single dose of soluble aspirin 1200 mg provided a more rapid onset, and a longer duration of analgesia, than the same dose of conventional aspirin (Seymour et al, 1986). The aim of the present study was to investigate the doseresponse relationship of soluble and conventional preparations of aspirin in patients with postoperative pain after removal of impacted third molars.…”