Does Adding Small Doses of Codeine Increase Pain Relief After Third Molar Surgery?

Abstract

Single and multiple dose analgesic efficacy and side-effect profile of two tablets of a combination of codeine (6.8 mg. aspirin 250 mg. and acetaminophen 250 mg were compared in a double-blind crossover study in 50 patients with pain after third molar surgery with a combination containing the same aspirin and acetaminophen doses, but without the codeine. There was no measurable difference in analgesic efficacy after a single dose: no measurable difference was found over the first two postoperative days. even though a mean of 133 mg of codeine was taken in addition to aspirin and acetaminophen. The codeine combination resulted in significantly more nausea, but also in significantly, less infection of the operative site. No analgesic benefit of adding low doses of codeine (13.6 mg/dose) to an aspirin and acetaminophen combination was seen, and the threshold codeine dose which produces measurable benefit is not known.