normally we use ibuprofen and paracetamol combination or ketorol or aceclofenac. but there is difference in responce in different patients.
There is ASA review in this subject from 2005 if I am not mistaken. It states that as long as you use the daily maximum dosage there is no difference between them.
The nnt number needed to treat is a good comparative measure of analgesics efficacy. But the data is an estimate derived from many study results. The best analgesic would gave nnt of 1. The pain by the way is maximum in first 12 hours. If you administer a long acting bupivacaine block at end of procedure, the analgesic requirements may be lessened. Preemptive analgesic is also a good idea. So there is no best analgesic but good pain management strategy rather. Moreover the response may vary among different patients and after same procedure.
PAIN RELIEF FOR POSTOPERATIVE PATIENTS
The most effective single dose oral analgesics for acute postoperative pain in adults have been identified by Oxford researchers in a Cochrane review of 45,000 participants across 350 studies.
Over 70% of participants with moderate or severe acute pain who took a single-dose achieved good pain relief with 120mg etoricoxib (Arcoxia) or the combination of 500mg paracetamol plus 200mg ibuprofen.
With other drugs, such as 1,000mg aspirin and 600mg paracetamol taken on their own, only 35% benefitted.
The worst was codeine, with only 14% getting significant pain relief. The period over which pain was relieved also varied, from about two hours to about 20 hours.
So everyone is different and you will find what works for you. It may be different to that which works for your friends.
mefenamic acid is a low cost and effective analgesic for wisdom tooth surgery
İf you have metamizol is best analgesic. It is almost equşvalent to morphine and non addicted. Look pubmed!
NSAI selective or none selective are the best overall in efficacy and side effects profile,This why 3 molar pain is the best pain model for testing analgesics .
Metamizole has been withdrawn from many countries because of the high incidence of agranulocytosis and other serious side effects such as anaphylactic shock.
Combination of intravenous paracetamol 1 gram and 100mg tramadol i/v half an hour before extubation works very nicely.You can give ondansetron along with tramadol for post operative vomitting.
go to the bandolier site www;have a look at the table of the analgesics .It shows that COX 2 and simple analgesics like aspirin and paracetamol are the best option.Many studies on the association of NSAID+ weak opioid are of modest quality and do not qualify for comparison with the best conducted studies;these should be comparative vs placebo,double blind,randomized...and asses results according to the NNT values as suggested by McQuay et al.
- Badges
- Science topic
- Similar topics
- Papers