Paracetamol an effective analgesic, but adding codeine gives additional benefit

Abstract

Objective To assess the analgesia obtained from single oral doses of paracetamol alone and with codeine. Data sources A search of the following databases, Medline 1966–1996, Embase 1980–1996, Cochrane Library Issue 2, 1996, Oxford Pain Relief Database 1950–1994, reference lists and textbooks, using a detailed search strategy. Study selection Only full journal publication of double-blind studies with randomly allocated adult patients receiving postoperative oral administration for treatment of moderate to severe pain baseline pain (equates to >30mm on a visual analogue scale, VAS), using acceptable pain measures. Results Thirty-one trials met the inclusion criteria of which 19 related to dental pain for paracetamol versus placebo, 19 trials for paracetamol and codeine versus placebo (14 dental) and 13 for paracetamol and codeine versus paracetamol alone (10 dental). Conclusion Paracetamol is an effective analgesic, and the addition of 60mg of codeine produces worthwhile additional pain relief. Moore A, Collins S, Carroll D, McQuay HJ. Paracetamol with and without codeine in acute pain: a quantitative systematic review. Pain 1997; 77:193–201