Ragg et al., 1997. Premedication 4 point pain face Paracetamol vs Pain scores were similar and analgesia for rating scale Painstop in both treatment arms. myringotomy in (paracetamol 12 mg, Little need for children codeine 0.5 mg and additional analgesia promethazine 0.65 p<0.03. mg per ml) 30 to 60 minutes prior to surgery Skjelbred et al., Oral surgical 100 mm VAS Paracetamol + No increase in analgesia 1982. procedures codeine phosphate was demonstrated by (400 mg + 30 mg), vs the addition of codeine plain paracetamol to paracetamol. The (400 mg) majority of participants (n=20) preferred treatment with plain paracetamol over the combination (n-4) p<0.001. Sniezek et al., Postoperative VAS Patients undergoing The group administered 2011. pain relief MMS and the combination of reconstruction paracetamol + for head and neck ibuprofen had the skin cancers lowest pain scores received 1 g (mean change from paracetamol baseline/immediately paracetamol plus prior to surgery) at each 400mg postoperative recorded ibuprofen, or 325mg time interval and a paracetamol plus significantly smaller 30mg codeine change from baseline immediately after pain scores than the surgery and every 4 paracetamol + codeine hours for up to four group at 4 hours (p = doses 0.005) and the paracetamol group at 8 hours (p = 0.02). Walton et al., 1990 Post-operative Five point verbal Ibuprofen 300 mg There was no oral surgery pain rating scale tablets vs ibuprofen statistically significant 300 mg + codeine 20 difference mg tablets in the effectiveness of either preparation in the control of postoperative pain. Both preparations were reported to provide good pain relief throughout the study.
Ragg et al., 1997. Premedication and analgesia for myringotomy in children 4 point pain face rating scale Paracetamol vs Painstop (paracetamol 12 mg, codeine 0.5 mg and promethazine 0.65 mg per ml) 30 to 60 minutes prior to surgery Pain scores were similar in both treatment arms. Little need for additional analgesia p<0.03. Skjelbred et al., 1982. Oral surgical procedures 100 mm VAS Paracetamol + codeine phosphate (400 mg + 30 mg), vs plain paracetamol (400 mg) No increase in analgesia was demonstrated by the addition of codeine to paracetamol. The majority of participants (n=20) preferred treatment with plain paracetamol over the combination (n-4) p<0.001. Sniezek et al., 2011. Postoperative pain relief VAS Patients undergoing MMS and reconstruction for head and neck skin cancers received 1 g paracetamol paracetamol plus 400mg ibuprofen, or 325mg paracetamol plus 30mg codeine immediately after surgery and every 4 hours for up to four doses The group administered the combination of paracetamol + ibuprofen had the lowest pain scores (mean change from baseline/immediately prior to surgery) at each postoperative recorded time interval and a significantly smaller change from baseline pain scores than the paracetamol + codeine group at 4 hours (p = 0.005) and the paracetamol group at 8 hours (p = 0.02). Walton et al., 1990 Post-operative oral surgery pain Five point verbal rating scale Ibuprofen 300 mg tablets vs ibuprofen 300 mg + codeine 20 mg tablets There was no statistically significant difference in the effectiveness of either preparation in the control of postoperative pain. Both preparations were reported to provide good pain relief throughout the study.
review-efficacy-and-safety-over-counter-codeine-combination-medicines.docx