Multicenter clinical trial of ibuprofen and acetaminophen in the treatment of postoperative dental pain

Article Abstract:

The abilities of two nonsteroidal analgesic agents, acetaminophen and ibuprofen, to relieve dental pain following oral surgery were compared. Seven hundred and six patients were studied at several research centers after they had undergone difficult tooth extractions, alveolectomy (removal of the bone of the upper or lower jaw in which the tooth sockets lie), multiple extractions, and other extensive dental procedures. Patients were randomly assigned to receive either ibuprofen (312 patients), acetaminophen (309), or an inactive placebo (85), according to an experiment design that assigned more patients to the two treatment groups than to the placebo group. The intensity of their dental pain was recorded before the medication was taken (baseline), then at regular intervals afterwards. Severity was rated as 1 (none), 2 (mild), 3 (moderate), or 4 (severe). Pain present after taking the analgesic or placebo was rated (also at regular intervals) as 1 (all gone), 2 (more than half gone). 3 (less than half gone), and 4 (no relief). Results for the 697 patients from whom acceptable data were collected showed that ibuprofen had a lower remedication rate (i.e. the patient requested additional medication less often; 41 percent) than acetaminophen (57 percent) or placebo (75 percent). Ibuprofen began to have a greater effect than acetaminophen on pain intensity at the rating period two hours after baseline and continued through hour six. Pain relief scores, too, showed the superiority of this agent. Statistically derived measures of total pain relief also showed that ibuprofen was more effective. The advantages of the oral surgery model of pain for testing analgesics are discussed. They include the relative uniformity of the procedures that produce pain and the fact that patients undergoing such treatments are usually healthy. In summary, ibuprofen appears to be a preferred analgesic for alleviating postoperative dental pain in patients for whom it is not contraindicated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Surgery, Drug therapy, Pain, Mouth, Stomatognathic system, Orofacial pain, Facial pain, Analgesics

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Antipyretic efficacy of ibuprofen and acetaminophen in children with febrile seizures

Article Abstract:

Ibuprofen appears to be more effective than acetaminophen at reducing fever in children prone to febrile seizures. Seventy children ranging in age from 10 months to 4 years and with a prior febrile seizure were randomly assigned to receive oral ibuprofen or oral acetaminophen during the next fever episode. Parents medicated the child every six hours for one to three days and periodically recorded rectal temperatures for the first 24 hours after the first dose. Children who had a repeat episode of fever during the study period were given the other medication. The temperature at 4 hours after the first dose, the time of greatest effectiveness, averaged 0.5 degrees centigrade lower in the group given ibuprofen. The mean temperature and the highest recorded temperature averaged 0.3 degrees centigrade lower. Ibuprofen was also found to be more effective in children having both medications because they had subsequent episodes of fever.

Care and treatment, Prevention

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Temperature, Age, and Recurrence of Febrile Seizure

Article Abstract:

Recurrent seizures in children with a fever generally occur within the first two hours of fever onset, and are more common in younger children. Researchers evaluated the risks of recurrent febrile seizure in 230 children with a history of seizure associated with fever. The risk of recurrent seizure during a subsequent fever was 30% greater in children with recurrent fever within six months of the first febrile seizure, and the risk declined with increasing age.

Complications and side effects, Risk factors

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