Relative efficacy of oral analgesics after third molar extraction

Barden, Jodie; Edwards, Jayne E; McQuay, Henry J; Wiffen, Philip J; Moore, Richard A.

doi:10.1038/sj.bdj.4811721

Cited by 116 publications

(54 citation statements)

References 30 publications

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“…Ibuprofen, paracetamol, aspirin (Barden et al, 2004 Level I) and celecoxib (Derry et al, 2008 Level I;Cheung et al, 2007 Level II) were found to be effective in this setting. Interestingly, the placebo response for analgesia was significantly lower in postdental extraction pain than in other acute pain models (Barden et al, 2004 Level I).…”

Section: Acute Postoperative Dental Painmentioning

confidence: 97%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Acute Postoperative Dental Painmentioning

confidence: 97%

“…However, it may sometimes be reasonable to extrapolate estimates of analgesic efficacy from one pain model to another (Barden et al, 2004 Level I).…”

Section: Painmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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show abstract

“…Several studies have shown that non steroidal antiinflammatory drugs, such as ibuprofen, are more effective than paracetamol for relieving dental pain. 25,26 Questionnaires were used to assess prescribing in order to collect diagnosis related data and to distinguish between antibiotics prescribed for the management of acute dental pain and antibiotics prescribed for prophylaxis. The fact that practitioners had to complete a questionnaire each time they saw a patient with acute dental pain might have focused the attention of practitioners in all three groups and thus reduced their prescribing.…”

Section: Researchmentioning

confidence: 99%

A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting

et al. 2006

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“…Several non-steroidal anti-inflammatory drugs (NSAIDS) have been used for pain, trismus and swelling control after lower third molar surgeries (2)(3)(4)(5)(6). The therapeutic effect of these medications is based on the inhibition of cyclooxygenases (COX), which determines an inhibition of prostaglandin production (7).…”

Section: Introductionmentioning

confidence: 99%

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

Benetello

Sakamoto

Giglio

et al. 2007

Braz J Med Biol Res

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We compared the clinical efficacy of orally administered valdecoxib and piroxicam for the prevention of pain, trismus and swelling after removal of horizontally and totally intrabony impacted lower third molars. Twenty-five patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Valdecoxib (40 mg) or piroxicam (20 mg) was administered in a double-blind, randomized and crossed manner for 4 days after the surgical procedures. Objective and subjective parameters were recorded for comparison of postoperative courses. Both agents were effective for postoperative pain relief (N = 19). There was a similar mouth opening at suture removal compared with the preoperative values (86.14 ± 4.36 and 93.12 ± 3.70% of the initial measure for valdecoxib and piroxicam, respectively; ANOVA). There was no significant difference regarding the total amount of rescue medication taken by the patients treated with valdecoxib or piroxicam (173.08 ± 91.21 and 461.54 ± 199.85 mg, respectively; Wilcoxon test). There were no significant differences concerning the swelling observed on the second postoperative day compared to baseline measures (6.15 ± 1.84 and 8.46 ± 2.04 mm for valdecoxib and piroxicam, respectively; ANOVA) or on the seventh postoperative day (1.69 ± 1.61 and 2.23 ± 2.09 mm for valdecoxib and piroxicam, respectively; ANOVA). The cyclooxygenase-2 selective inhibitor valdecoxib is as effective as the non-selective cyclooxygenase inhibitor piroxicam for pain, trismus and swelling control after removal of horizontally and totally intrabony impacted lower third molars.

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Relative efficacy of oral analgesics after third molar extraction

Cited by 116 publications

References 30 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

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