***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: DFP [ 3-(2-propyloxy)-(4-methyl-sulfonylphenyl)-(5,5-dimethyl)-fu ranone ] is a highly specific cyclooxygenase-2 inhibitor ( > 2500-fold selective in transfected Chinese hamster ovary cell assays ) that has demonstrated efficacy in pre clinical models of pain and inflammation . The present single-dose , r and omized , double-masked , double-dummy , placebo-controlled , parallel-group study was undertaken to compare DFP 5 , 25 , and 50 mg with naproxen sodium 550 mg and with placebo in 196 patients ( mean age , 25.8 years ; 187 [ 95.4 % ] males ) who experienced moderate-to-severe pain after surgical removal of > or = 2 third molars .  Overall analgesic effect , duration of effect , time to onset of analgesic effect , peak analgesic effect , and tolerability were assessed over a 24-hour postdose period . Both DFP 25 and 50 mg , as well as the active comparator , naproxen sodium 550 mg , were significantly more effective than placebo . The onset of analgesic effect in the DFP 25-mg , DFP 50-mg , and naproxen sodium 550-mg groups did not differ significantly . DFP was generally well tolerated in single doses up to 50 mg . DFP 50 mg was efficacious in the treatment of postoperative dental pain and was indistinguishable from the active comparator , naproxen sodium 550 mg Abstract  Variability  in patients ' response to interventions in pain and other clinical setting s is large . Many explanations such as trial methods , environment or culture have been proposed , but this paper sets out to show that the main cause of the variability may be r and om chance , and that if trials are small their estimate of magnitude of effect may be incorrect , simply because of the r and om play of chance . This is highly relevant to the questions of ‘ How large do trials have to be for statistical accuracy ? ’ and ‘ How large do trials have to be for their results to be clinical ly valid ? ’ The true underlying control event rate ( CER ) and experimental event rate ( EER ) were determined from single‐dose acute pain analgesic trials in over 5000 patients . Trial group size required to obtain statistically significant and clinical ly relevant ( 0.95 probability of number‐needed‐to‐treat within ±0.5 of its true value ) results were computed using these values . Ten thous and trials using these CER and EER values were simulated using varying group sizes to investigate the variation due to r and om chance alone . Most common analgesics have EERs in the range 0.4–0.6 and CER of about 0.19 . With such efficacy , to have a 90 % chance of obtaining a statistically significant result in the correct direction requires group sizes in the range 30–60 . For clinical relevance nearly 500 patients are required in each group . Only with an extremely effective drug ( EER>0.8 ) will we be reasonably sure of obtaining a clinical ly relevant NNT with commonly used group sizes of around 40 patients per treatment arm . The simulated trials showed substantial variation in CER and EER , with the probability of obtaining the correct values improving as group size increased . We contend that much of the variability in control and experimental event rates is due to r and om chance alone . Single small trials are unlikely to be correct . If we want to be sure of getting correct ( clinical ly relevant ) results in clinical trials we must study more patients . Credible estimates of clinical efficacy are only likely to come from large trials or from pooling multiple trials of conventional ( small ) size We compared naproxen sodium ( 550 mg ) and propoxyphene napsylate with acetaminophen ( PN/A , 100 mg with 650 mg ) for pain relief  after arthroscopy or arthroscopic meniscectomy . Fifty-two patients entered this multicenter , double-blind , r and omized , parallel trial . In each drug group , pain intensity values dropped consistently throughout this six-hour study from mean baseline levels of approximately 55 on a scale of 0 to 100 . Pain intensity values were lower at each hour in the naproxen sodium than in the PN/A group and significantly lower at hour 1 ( P=.008 ) . Pain intensity differences ( PID , reflecting change from baseline ) mirrored this trend : greater mean PIDs were seen in the naproxen sodium group at each hour , and this difference between drug groups was statistically significant at hour 1 ( P=.017 ) . One patient in the naproxen sodium group and seven patients using PN/A took a second dose within the six hours . Patients in each drug group reported five complaints Abstract A multidisciplinary , double blind , parallel placebo controlled investigation was made to find an effective anti-inflammatory drug which prevents  postoperative swelling , trismus and a general feeling of malaise . An additional aim was to evaluate objective ly the anti-inflammatory properties of anti-rheumatics . In 126 healthy patients , who were without complaints , the lower third molar was surgically removed . A drug had to be taken orally according to a fixed scheme for 4 days . Glafenine had to be taken in case of pain . The number of tablets taken was used to quantify pain . Swelling of the cheek was measured photographically and trismus was deducible from the maximal mouth-opening . The drugs investigated were betamethasone 14.5 mg decreasing over 4 days , ibuprofen 1200 mg/day , indomethacin 150 mg/day , naproxen 750 mg/day , niflumic acid 1000 mg/day , oxyphenylbutazone 600 mg/day and tranexamic acid 2000 mg/day . Oxyphenylbutazone and tranexamic acid were not significantly different from placebo in their pain-killing effects .  Betamethasone  prevents swelling and trismus significantly more than the placebo . Betamethasone is significantly better than the other drugs in the prevention of swelling . Reduction of the swelling by anti-rheumatics may be 10–15 % and a 20 % reduction of trismus is to be expected . The strongest analgesic is niflumic acid . Tranexamic acid may perhaps reduce the swelling by 28 % . The question naire and the blood- and urine-test showed that anti-rheumatics have to be considered to be acetylsalicylic acid-like drugs . Serious side effects have been reported previously for anti-rheumatics . When taken for a short time , corticosteroids are very safe drugs with a few mild side-effects . Many patients experience a slight euphoria .  Betamethasone , in a dosage of 14.5 mg decreasingly divided over 4 days prevents pain by 80 % , swelling by 65 % and trismus by 40 % compared with the placebo group . This safe drug is recommended in elective surgery A r and omized , single-blind , parallel study involving 100 adults was performed to compare the efficacy and safety of naproxen sodium with that of pirprofen in the treatment of moderate to severe pain after orthopaedic surgery . Fifty patients received 550 mg of naproxen sodium initially and 275 mg every 6 h thereafter , and 50 received 400 mg of pirprofen every 8 h until either their pain was completely relieved or the 3-day trial ended . Patients who required additional analgesia were given 500 mg of paracetamol 2 h after administration of the test medication . Both medications significantly relieved post-operative pain , and there were no statistically significant differences in efficacy between the groups . Six patients receiving naproxen sodium and two patients receiving pirprofen withdrew from the study because of lack of efficacy .  Thirteen patients receiving  naproxen sodium recorded 17 adverse events and 13 patients receiving pirprofen recorded 20 adverse events , again with no statistically significant differences between groups . Six patients in each group withdrew from the study because of these adverse events .  Naproxen sodium and pirprofen were equally safe and effective in relieving post-operative pain following musculoskeletal surgery Oral naproxen in doses of 100 , 200 and 400 mg was compared with oral meperidine in doses of 25 and 75 mg , in a double-blind , single-dose , completely-r and omized study of patients with postoperative pain . One hundred patients were studied , twenty for each of the five treatments . The patients 1 subjective pain scores were recorded by an observer for four hours after administration of the treatment . Dose-effect trends were present with both naproxen and meperidine . Naproxen 400 mg performed the best of all treatments in the study ; on pain-score measurements it was significantly superior to meperidine 25 mg ; and in terms of the number of patients requiring re-medication for pain during the four-hour observation period , significantly fewer patients failed on naproxen 400 than on naproxen 100 mg . No appreciable excess of side effects occurred with naproxen A single-blind , parallel study was carried out in 54 patients with post-operative pain after minor orthopaedic procedures to compare the efficacy and tolerance of naproxen sodium and dihydrocodeine tartrate . Patients were allocated at r and om to receive oral treatment as soon as analgesia became necessary with an initial dose of either 550 mg naproxen sodium or 30 mg dihydrocodeine tartrate , then doses of 275 mg and 30 mg , respectively , when required up to a maximum of 5 doses per day for 3 days . Assessment s were made of pain severity and pain relief 2 and 4 hours after the first dose and at the end of each day . The results indicated that naproxen sodium gave statistically significantly greater pain relief than dihydrocodeine tartrate after the first dose . Both treatments were well tolerated and few side-effects were reported . Three patients in each group were withdrawn due to lack of efficacy ( combined with adverse effects in 1 naproxen sodium patient ) , and 1 patient in each group was withdrawn because of side-effects A double-blind parallel r and omized study comparing naproxen 600 mg , naproxen 400 mg , and propoxyphene 65 mg was performed in 105 patients suffering from pain after orthopedic surgery . A significant difference in analgesic effectiveness was shown between the three drugs with successful analgesia recorded in 66 % of patients who received naproxen 600 mg , 37 % of those who received naproxen 400 mg , and 20 % of those who received propoxyphene 65 mg ( X2 2dt= 15.34 , p<0.005 ) . Naproxen 600 mg provided successful analgesia more often than did naproxen 400 mg . Complaints were mild but frequent with ail drugs ( 36 % of patients ) . No serious side effects were & NA ; There is uncertainty over whether the patient group in which acute pain studies are conducted ( pain model ) has any influence on the estimate of analgesic efficacy . Data from four recently up date d systematic review s of aspirin 600/650 mg , paracetamol 600/650 mg , paracetamol 1000 mg and ibuprofen 400 mg were used to investigate the influence of pain model . Area under the pain relief versus time curve equivalent to at least 50 % maximum pain relief over 6 h was used as the outcome measure . Event rates with treatment and placebo , and relative benefit ( RB ) and number needed to treat ( NNT ) were used as outputs from the meta‐analyses . The event rate with  placebo was systematic ally statistically lower for dental than postsurgical pain for all four treatments . Event rates with analgesics , RB and NNT were infrequently different between the pain models . Systematic difference in the estimate of analgesic efficacy between dental and postsurgical pain models remains unproven , and , on balance , no major difference is likely Using a within-subject , crossover experimental design , this study compared the efficacies of a nonsteroidal anti-inflammatory drug , naproxen sodium , 550 mg , administered either 30 minutes preoperatively or 30 minutes postoperatively to 36 patients undergoing the removal of impacted third molar teeth .  Pain intensity was assessed postoperatively for 8 hours . Treatment with naproxen sodium , 550 mg , 30 minutes following completion of surgery was just as effective as presurgical administration in controlling postoperative pain . Administration of naproxen sodium in the immediate postoperative period may be indicated for optimum postoperative analgesia for patients in whom preoperative oral intake is contraindicated BACKGROUND The aim of this prospect i ve , r and omized study is to compare the efficacy and safety of ibuprofen L-arginine and naproxen in the treatment of postoperative dental pain .  METHODS Seventy patients undergoing removal of impacted third molars were r and omly allocated to receive 4 hours after surgery a single oral dose of either ibuprofen L-arginine 400 mg or naproxen 550 mg .  Ten patients dropped out from the study because they took the study drug before the allowed time . Using a self-rating record , patients rated their pain and its relief for 1 hour after the drug administration . Remedication , if needed , and mean time of remedication were also recorded . RESULTS A statistically significant reduction in pain scores with respect to the baseline values was recorded 5 minutes and 15 minutes after the drug administration in the i 
    Output:
    
There was no significant difference between the number of patients experiencing any adverse event on treatment compared with placebo .
REVIEW ERS ' CONCLUSIONS Naproxen sodium 550 mg , naproxen 400 mg and naproxen sodium 440 mg administered orally are effective analgesics for the treatment of acute postoperative pain in adults .
A low incidence of adverse events was found but reporting was not consistent