Comparative study of intravenous flurbiprofen and acetaminophen for preventing pain after third molar surgery: A retrospective cohort study

Objective

In the general management of postoperative pain after third molar surgery under intravenous (IV) sedation, a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen is usually prescribed. However, there is no concrete evidence regarding whether an NSAID or acetaminophen is more effective. In this study, we assessed the efficacy of a single dose of IV NSAIDs (50 mg flurbiprofen axetil) compared with that of a single dose of 1000 mg acetaminophen in reducing pain when administered after impacted mandibular third molar surgery.

Methods

In this retrospective observational cohort study, we collected data from medical records of patients who underwent single mandibular molar surgery in a hospitalization setting under IV sedation from 2017 to 2021. We defined patients who received IV flurbiprofen axetil after surgery as the FLB group and those who received IV acetaminophen as the AA group. The primary study outcome was the maximum postoperative pain score during the first 5–15 h post-surgery. The secondary outcome was pain suppression time (the time of initial adjuvant analgesic dose [60 mg loxoprofen]) and the number of doses within 17 h post-surgery.

Results

The FLB group had significantly lower pain levels at 1, 2, and 3 h postoperatively than the AA group. In addition, the FLB group showed significantly lower adjunct analgesic consumption.

Conclusions

IV NSAID administration after impacted mandibular third molar surgery provided more effective pain control than IV acetaminophen. This information can be used by clinicians, especially those working with patients with post-surgical pain, to improve patient care and recovery.