Shiraz E-Medical Journal

Published by: Kowsar

Clinical Trial of Combination of Acetaminophen, Ibuprofen and Caffeine on Pain Relief and Analgesic Use After Impacted Lower Third Molar Surgery

Hosein Kimiaei Asadi 1 , Mohammad Reza Jamalpour 2 , * and Arezoo Saeedi 3
Authors Information
1 Assosciate Professor, Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, IR Iran
2 Assosciate Professor, Department of Oral and Maxillofacial Surgery, Hamadan University of Medical Sciences, Hamadan, IR Iran
3 Dentistry College, Hamadan University of Medical Sciences, Hamadan, IR Iran
Article information
  • Shiraz E-Medical Journal: July 2017, 18 (7); e13092
  • Published Online: May 16, 2017
  • Article Type: Research Article
  • Received: March 5, 2017
  • Revised: April 27, 2017
  • Accepted: May 1, 2017
  • DOI: 10.5812/semj.13092

To Cite: Kimiaei Asadi H, Jamalpour M R, Saeedi A. Clinical Trial of Combination of Acetaminophen, Ibuprofen and Caffeine on Pain Relief and Analgesic Use After Impacted Lower Third Molar Surgery, Shiraz E-Med J. 2017 ; 18(7):e13092. doi: 10.5812/semj.13092.

Copyright © 2017, Shiraz University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Garcia Garcia A, Gude Sampedro F, Gandara Rey J, Gallas Torreira M. Trismus and pain after removal of impacted lower third molars. J Oral Maxillofac Surg. 1997; 55(11): 1223-6[PubMed]
  • 2. Clauser B, Barone R, Briccoli L, Baleani A. Complications in surgical removal of mandibular third molars. Minerva Stomatol. 2009; 58(7-8): 359-66[PubMed]
  • 3. Berge TI, Boe OE. Predictor evaluation of postoperative morbidity after surgical removal of mandibular third molars. Acta Odontol Scand. 1994; 52(3): 162-9[PubMed]
  • 4. Seymour RA, Blair GS, Wyatt FA. Post-operative dental pain and analgesic efficacy. Part I. Br J Oral Surg. 1983; 21(4): 290-7[PubMed]
  • 5. Berge TI. The use of a visual analogue scale in observer assessment of postoperative swelling subsequent to third-molar surgery. Acta Odontol Scand. 1989; 47(3): 167-74[PubMed]
  • 6. Nørholt SE, Aagaard E, Svensson P, Sindet-Pedersen S. Evaluation of trismus, bite force, and pressure algometry after third molar surgery: A placebo-controlled study of ibuprofen. J Oral Maxillofac Surg. 1998; 56(4): 420-7[DOI]
  • 7. Fisher SE, Frame JW, Rout PG, McEntegart DJ. Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br Dent J. 1988; 164(11): 351-4[PubMed]
  • 8. Duker JS, Nielsen J, Vander JF, Rosenstein RB, Benson WE. Retrobulbar bupivacaine irrigation for postoperative pain after scleral buckling surgery. A prospective study. Ophthalmology. 1991; 98(4): 514-8[PubMed]
  • 9. Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007; 19(1): 117-28[DOI][PubMed]
  • 10. Kiersch TA, Halladay SC, Hormel PC. A single-dose, double-blind comparison of naproxen sodium, acetaminophen, and placebo in postoperative dental pain. Clin Ther. 1994; 16(3): 394-404[PubMed]
  • 11. Mehlisch DR, Sollecito WA, Helfrick JF, Leibold DG, Markowitz R, Schow CJ, et al. Multicenter clinical trial of ibuprofen and acetaminophen in the treatment of postoperative dental pain. J Am Dent Assoc. 1990; 121(2): 257-63[PubMed]
  • 12. Cooper SA, Schachtel BP, Goldman E, Gelb S, Cohn P. Ibuprofen and acetaminophen in the relief of acute pain: a randomized, double-blind, placebo-controlled study. J Clin Pharmacol. 1989; 29(11): 1026-30[PubMed]
  • 13. Derry CJ, Derry S, Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2012; (3)[DOI][PubMed]
  • 14. Lavand'homme PM, Roelants F, Waterloos H, De Kock MF. Postoperative analgesic effects of continuous wound infiltration with diclofenac after elective cesarean delivery. Anesthesiology. 2007; 106(6): 1220-5[DOI][PubMed]
  • 15. Yeganeh Mogadam A, Fazel MR, Parviz S. Comparison of analgesic effect between gabapentin and diclofenac on post-operative pain in patients undergoing tonsillectomy. Arch Trauma Res. 2012; 1(3): 108-11[DOI][PubMed]
  • 16. Javid MJ, Hajijafari M, Hajipour A, Makarem J, Khazaeipour Z. Evaluation of a low dose ketamine in post tonsillectomy pain relief: a randomized trial comparing intravenous and subcutaneous ketamine in pediatrics. Anesth Pain Med. 2012; 2(2): 85-9[DOI][PubMed]
  • 17. Kimiaei Asadi H, Nikooseresht M, Noori L, Behnoud F. The Effect of Administration of Ketamine and Paracetamol Versus Paracetamol Singly on Postoperative Pain, Nausea and Vomiting After Pediatric Adenotonsillectomy. Anesth Pain Med. 2016; 6(1)[DOI][PubMed]
  • 18. Jain C, Sinha M, Rani R, Tiwari A. Glyceryl trinitrate patch versus intravenous ritodrine for tocolysis in pre-term labour. Int J Reprod Contracept Obstetr Gynecol. 2016; 5(12): 4447-52
  • 19. Christensen S, Paluch E, Jayawardena S, Daniels S, Meeves S. Analgesic Efficacy of a New Immediate‐Release/Extended‐Release Formulation of Ibuprofen: Results From Single‐and Multiple‐Dose Postsurgical Dental Pain Studies. Clin Pharmacol Drug Dev. 2016;
  • 20. Menke ER, Jackson CR, Bagby MD, Tracy TS. The effectiveness of prophylactic etodolac on postendodontic pain. J Endod. 2000; 26(12): 712-5[DOI][PubMed]
  • 21. Wells LK, Drum M, Nusstein J, Reader A, Beck M. Efficacy of Ibuprofen and ibuprofen/acetaminophen on postoperative pain in symptomatic patients with a pulpal diagnosis of necrosis. J Endod. 2011; 37(12): 1608-12[DOI][PubMed]
  • 22. Goldstein J, Silberstein SD, Saper JR, Ryan RJ, Lipton RB. Acetaminophen, aspirin, and caffeine in combination versus ibuprofen for acute migraine: results from a multicenter, double-blind, randomized, parallel-group, single-dose, placebo-controlled study. Headache. 2006; 46(3): 444-53[DOI][PubMed]
  • 23. Mense S. Sensitization of group IV muscle receptors to bradykinin by 5-hydroxytryptamine and prostaglandin E2. Brain Res. 1981; 225(1): 95-105[PubMed]
  • 24. van der Westhuijzen AJ, Roelofse JA, Grotepass FW, Becker PJ. Randomized double-blind comparison of tiaprofenic acid and diclophenac sodium after third molar surgery. Oral Surg Oral Med Oral Pathol. 1994; 78(5): 557-66[PubMed]
  • 25. Jackson DL, Moore PA, Hargreaves KM. Preoperative nonsteroidal anti-inflammatory medication for the prevention of postoperative dental pain. J Am Dent Assoc. 1989; 119(5): 641-7[PubMed]
  • 26. Coulthard P, Hill CM, Frame JW, Barry H, Ridge BD, Bacon TH. Pain control with paracetamol from a sustained release formulation and a standard release formulation after third molar surgery: a randomised controlled trial. Br Dent J. 2001; 191(6): 319-24[DOI][PubMed]
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