Does Preemptive administration of IV ibuprofen (Caldolor®) IV acetaminophen (Ofirmev®) reduce postoperative pain and subsequent narcotic consumption following third molar surgery?

Publication date: Available online 20 September 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Archana Viswanath, Daniel Oreadi, Matthew Finkelman, Gustavo Klein, Maria Papageorge

Purpose

Preemptive analgesia is known to reduce postoperative pain following third molar removal. The purpose of this study was to compare postoperative pain in subjects receiving either preoperative IV ibuprofen or IV acetaminophen for third molar surgery.

Methods

This study was a randomized single blinded clinical study conducted in subjects undergoing surgical extraction of two or more impacted third molars under deep sedation. This study compared two interventions 800 mg Caldolor (IV ibuprofen) and 1000 mg Ofirmev (IV acetaminophen). The primary outcome variable was postoperative pain measured at different time points on the visual analog scale (VAS). The secondary outcome variable was amount of postoperative analgesic (narcotic and over the counter) medications taken in both the groups. Mann-Whitney U test were used to compare groups, outcomes Chi-square test was used to assess associations between nominal variables, and the Spearman correlation was used to assess associations between continuous variables. Significance was set at P < .05

Results

The study sample consisted of 58 (female 39 male 19) subjects. Forty-one subjects (IV ibuprofen n=19, IV acetaminophen n=22) completed the study. There was equal distribution of age, gender, number of impacted teeth between the groups. At 4 hours postoperative period pain levels in the ibuprofen group was significantly lower than acetaminophen group (p=0.004). This trend continued at 24 hours (p=0.019), 48 hours (p=0.017).The average amount of narcotic medications taken in the ibuprofen (2.68±2.26) group was lower than the acetaminophen (7.32±6.68) group and the results were statistically significant (p=0.005).

Conclusions

Preemptive analgesia with IV ibuprofen is more effective than IV acetaminophen in reducing postoperative pain and opioid use for third molar surgery.

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