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Ketoprofen 75 mg qid versus Acetaminophen 1000 mg qid for 3 Days on Swelling, Pain, and Other Postoperative Events after Third-Molar Surgery

From the Section of Dental Pharmacology and Pharmacotherapy (Dr. Bjørnsson, Dr. Skoglund) and the Department of Oral Medicine and Oral Surgery (Dr. Bjørnsson, Dr. Haanæs), University of Oslo, Oslo, Norway.

A randomized, double-blind, within-patient, crossover study was carried out after bilateral "identical" surgical procedures using local anesthesia only. A 3-day tablet regime of racemic ketoprofen 75 mg or acetaminophen 1000 mg qid (x 4) was given starting 3 hours after surgery. Ketoprofen reduced objectively measured swelling 27.8% (p < 0.04) better than acetaminophen 3 days after surgery and 70.8% (p < 0.02) better than acetaminophen 6 days after surgery. The pain intensity (PI) was lower after ketoprofen than after acetaminophen from 2 to 6 hours after the first drug intake (all p-values 0.03). Sum PI during the first (SUMPI_3.5-6, p = 0.003) and second dose intervals (SUMPI_6.5-9, p = 0.007) was lower for ketoprofen than for acetaminophen but not different for the third dose interval (SUMPI_9.5-11, p = 0.53). Ketoprofen was a more effective analgesic than acetaminophen on the day of surgery (SUMPI_3.5-11, p = 0.005). There was no difference (p > 0.05) between the treatments with respect to mouth opening, drug preference, global evaluation, or adverse reports. Adverse reports included stomach pain and diarrhea in both treatment groups. Ketoprofen 75 mg x 4 for 3 days reduces subjectively assessed pain and objectively measured swelling (i.e., anti-inflammatory effect) following third-molar surgery.

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