Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Oral and Maxillofacial Surgery
Published in: Oral and Maxillofacial Surgery 1/2021

01-03-2021 | Tooth Extraction | Original Article

Analgesia and side effects of codeine phosphate associated with paracetamol vs. paracetamol after the extraction of mandibular third molars: a randomized double-blind clinical trial using the split-mouth model

Authors: Matheus Furtado de Carvalho, Yuri Slusarenko da Silva, Peter Reher, Maria da Graça Naclério-Homem

Published in: Oral and Maxillofacial Surgery | Issue 1/2021

Login to get access

Abstract

Purpose

To assess the analgesia and side effects of codeine phosphate associated with paracetamol (test medication) as compared to paracetamol (control medication) after the extraction of impacted mandibular third molars.

Materials and methods

Forty-seven patients removed the right and left impacted mandibular third molars. After one surgery, patients took the test medication and after the other surgery, they took the control medication. Patients with exacerbated pain were prescribed to use the rescue medication instead of the medication initially administered and were included in the rescue group. They were evaluated for 7 days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Poisson distribution. The side effects of these medications were assessed by the patient’s complaints. A P value of < .05 was considered to be statistically significant.

Results

The mean score of the VAS of pain was not statistically different between test and control medications in the non-rescue group, but it was significantly greater in patients previously using paracetamol in the rescue group. The most common side effects reported in both groups, predominantly in patients using the test medication, were drowsiness, dizziness, and nausea.

Conclusion

The use of codeine phosphate associated with paracetamol after the extraction of impacted mandibular third molars is a better choice to control the postoperative pain rather than paracetamol, but with more side effects, which are clinically acceptable.
Literature
1.
Sirin Y, Humphris G, Sencan S, Firat D (2012) What is the most fearful intervention in ambulatory oral surgery? Analysis of an outpatient clinic. Int J Oral Maxillofac Surg 41:1284–1290CrossRef
2.
3.
Rosero EB, Joshi GP (2014) Preemptive, preventive, multimodal analgesia: what do they really mean? Plast Reconstr Surg 134:85S–93SCrossRef
4.
Mattia C, Coluzzi F (2015) A look inside the association codeine-paracetamol: clinical pharmacology supports analgesic efficacy. Eur Rev Med Pharmacol Sci 19:507–516PubMed
5.
Jung YS, Kim DK, Kim MK, Kim HJ, Cha IH, Lee EW (2004) Onset of analgesia and analgesic efficacy of tramadol/acetaminophen and codeine/acetaminophen/ibuprofen in acute postoperative pain: a single-center, single-dose, randomized, active-controlled, parallel-group study in a dental surgery pain model. Clin Ther 26:1037–1045CrossRef
6.
Chang DJ, Bird SR, Bohidar NR, King T (2005) Analgesic efficacy of rofecoxib compared with codeine/acetaminophen using a model of acute dental pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:74–80CrossRef
7.
Daniels SE, Bandy DP, Christensen SE, Boice J, Losada MC, Liu H, Mehta A, Peloso PM (2011) Evaluation of the dose range of etoricoxib in an acute pain setting using the postoperative dental pain model. Clin J Pain 27:1–8CrossRef
8.
Gatoulis SC, Voelker M, Fisher M (2012) Assessment of the efficacy and safety profiles of aspirin and acetaminophen with codeine: results from 2 randomized, controlled trials in individuals with tension-type headache and postoperative dental pain. Clin Ther 34:138–148CrossRef
9.
Brown JD, Daniels SE, Bandy DP, Ko AT, Gammaitoni A, Mehta A, Boice JA, Losada MC, Peloso PM (2013) Evaluation of multiday analgesia with etoricoxib in a double-blind, randomized controlled trial using the postoperative third-molar extraction dental pain model. Clin J Pain 29:492–498CrossRef
10.
Pell GJ, Gregory GT (1933) Impacted third molars: classification and modified technique for removal. Dent Digest 39:330–338
11.
Winter GB (1926) Principles of exodontia as applied to the impacted third molars: a complete treatise on the which clinical diagnosis and radiographics interpretation, 1st edn. American medical books, St Louis
12.
McCullagh P, Nelder JA (1989) Generalized linear models, 2nd edn. Chapman and Hall, LondonCrossRef
13.
Neter J, Kutner MH, Nachtsheim CJ, Wasserman W (1996) Applied linear statistical models, 4th edn. Richard D. Irwing, Ilinois
14.
Kirkwood B, Sterne J (2003) Essential medical statistics, 2nd edn. Blackwell Science, Oxford
15.
Pozos AJ, Martinez R, Aguirre P, Perez J (2006) The effects of tramadol added to articaine on anesthesia duration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:614–617CrossRef
16.
Jerjes W, Upile T, Nhembe F, Gudka D, Shah P, Abbas S, McCarthy E, Patel S, Mahil J, Hopper C (2010) Experience in third molar surgery: an update. Br Dent J 10:209 E1
17.
Seymour RA, Blair GS, Wyatt FAR (1983) Post-operative dental pain and analgesic efficacy. Part I. Br J Oral Surg 21:290–297CrossRef
18.
Lago-Méndez L, Diniz-Freitas M, Senra-Rivera C, Gude-Sampedro F, Rey JMG, García-García A (2007) Relationships between surgical difficulty and postoperative pain in lower third molar extractions. J Oral Maxillofac Surg 65:979–983CrossRef
19.
Alexander RE, Throndson RR (2000) A review of perioperative corticosteroid use in dentoalveolar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:406–415CrossRef
20.
Alcântara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML (2014) Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg 43:93–98CrossRef
21.
Darawade DA, Kumar S, Mehta R, Sharma AR, Reddy GS (2014) In search of a better option: dexamethasone versus methylprednisolone in third molar impaction surgery. J Int Oral Health 6:14–17PubMedPubMedCentral
22.
Chaudhary PD, Rastogi S, Gupta P, Niranjanaprasad Indra B, Thomas R, Choudhury R (2015) Pre-emptive effect of dexamethasone injection and consumption on post-operative swelling, pain, and trismus after third molar surgery. A prospective, double blind and randomized study. J Oral Biol Craniofac Res 5:21–27CrossRef
23.
Kurita GP, Benthien KS, Nordly M, Mercadante S, Klepstad P, Sjøgren P (2015) The evidence of neuraxial administration of analgesics for cancer-related pain: a systematic review. Acta Anaesthesiol Scand 59:1103–1115CrossRef
24.
Mehlisch DR (2002) The efficacy of combination analgesic therapy in relieving dental pain. J Am Dent Assoc 133:861–871CrossRef
Metadata
Title
Analgesia and side effects of codeine phosphate associated with paracetamol vs. paracetamol after the extraction of mandibular third molars: a randomized double-blind clinical trial using the split-mouth model
Authors
Matheus Furtado de Carvalho
Yuri Slusarenko da Silva
Peter Reher
Maria da Graça Naclério-Homem
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 1/2021
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-020-00888-x

Other articles of this Issue 1/2021

Oral and Maxillofacial Surgery 1/2021 Go to the issue

Case Report

Cervicofacial actinomycosis following third molar removal: case-series and review

Case Report

Development of Kikuchi–Fujimoto disease after a cervical lymph node metastasis of mucoepidermoid carcinoma: a case report

Case Report

Co-existence of cheilitis glandularis and actinic cheilitis—an update

Original Article

Neck dissection with harmonic instruments and electrocautery: a prospective comparative study

Original Article

Reconstruction using sternocleidomastoid muscle flap versus posterior belly of digastric muscle flap compared with no reconstruction following superficial parotidectomy

Case Report

Active decompression and distraction sugosteogenesis for the treatment of calcifying odontogenic cyst