Evaluation of ketorolac, aspirin, and an acetaminophen-codeine combination in postoperative oral surgery pain

• Published in: Pharmacotherapy Vol. 10; no. 6 ( Pt 2); p. 77S
• Main Authors: Forbes, J A, Butterworth, G A, Burchfield, W H, Beaver, W T
• Format: Journal Article
• Language: English
• Published: United States 01.01.1990
• Subjects: Acetaminophen - administration & dosage; Acetaminophen - therapeutic use; Administration, Oral; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Aspirin - administration & dosage; Aspirin - therapeutic use; Codeine - administration & dosage; Codeine - therapeutic use; Double-Blind Method; Drug Administration Schedule; Drug Combinations; Female; Humans; Ketorolac Tromethamine; Male; Pain Measurement; Pain, Postoperative - drug therapy; Time Factors; Tolmetin - administration & dosage; Tolmetin - analogs & derivatives; Tolmetin - therapeutic use; Tooth, Impacted - surgery; Tromethamine - administration & dosage; Tromethamine - therapeutic use
• ISSN: 0277-0008
• DOI: 10.1002/j.1875-9114.1990.tb03584.x

One-hundred twenty-eight outpatients with postoperative pain after the surgical removal of impacted third molars were randomly assigned, on a double-blind basis, to receive oral doses of ketorolac tromethamine 10 mg, aspirin 650 mg, a combination of acetaminophen 600 mg plus codeine 60 mg, or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 6 hours after medicating. All active medications were significantly superior to placebo. The acetaminophen-codeine combination was significantly superior to aspirin for peak analgesia. Ketorolac was significantly superior to aspirin for every measure of total and peak analgesia, and significantly superior to acetaminophen-codeine for measures of total effect. The analgesic effect of ketorolac was significant by hour 1 and persisted for 6 hours. Repeat-dose data also suggested that ketorolac 10 mg was superior to aspirin 650 mg and acetaminophen-codeine on the day of surgery. Differences among the active medications were trivial for the postoperative days 1-6 analyses. The frequency of adverse effects was over 4 times greater for acetaminophen-codeine than for ketorolac or aspirin.