• DOI:10.1093/BJA/AEI109
• Corpus ID: 2189415

Onset of acetaminophen analgesia: comparison of oral and intravenous routes after third molar surgery.

@article{Moller2005OnsetOA,
  title={Onset of acetaminophen analgesia: comparison of oral and intravenous routes after third molar surgery.},
  author={P L Moller and Steen Sindet‐Pedersen and Carsten Petersen and Gitte Irene Juhl and Anne Dillenschneider and Lasse A Skoglund},
  journal={British journal of anaesthesia},
  year={2005},
  volume={94 5},
  pages={
          642-8
        }
}

• P. L. Moller, S. Sindet‐Pedersen, +3 authors L. A. Skoglund
• Published 1 May 2005
• Medicine
• British journal of anaesthesia

BACKGROUND
The purpose of this randomized double-blind study was to compare the efficacy and safety of propacetamol 2 g (an i.v. acetaminophen 1 g formulation) administered as a 2-min bolus injection (n=50) or a 15-min infusion (n=50) with oral acetaminophen 1 g (n=50) or placebo (n=25) for analgesia after third molar surgery in patients with moderate to severe pain after impacted third molar removal.

METHODS
All patients were evaluated for efficacy during the initial 6 h period after treatment administration (T(0)) and for safety during the entire week after T(0).

RESULTS
The onset of analgesia after propacetamol was shorter (3 min for bolus administration, 5 min for 15-min infusion) than after oral acetaminophen (11 min). Active treatments were significantly better for all parameters (pain relief, pain intensity, patient's global evaluation, duration of analgesia) than placebo (P<0.05). Adverse events were more frequent after propacetamol, especially pain at the injection site. Propacetamol bolus resulted in a much higher incidence of local adverse events than the infusion (propacetamol bolus 90% vs propacetamol infusion 52%) with no clinically significant benefits in terms of analgesic efficacy.

CONCLUSION
I.V. propacetamol, administered as a 15-min infusion, is a fast-acting analgesic agent. It is more effective in terms of onset of analgesia than a similar dose of oral acetaminophen.