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When not contraindicated, naproxen sodium can be considered a preferred substitute to opioid combinations for the management of post-impaction surgery pain.
A randomized trial depicted that in people with postsurgical dental pain, naproxen sodium (440 mg) was at least as effective as the combination of hydrocodone and acetaminophen (10/650 mg) in the early hours, considerably more effective at minimizing pain, offered higher pain improvement over twelve hours, and showed good tolerability.
Stephen A Cooper et al. undertook this study to compare naproxen sodium against hydrocodone plus acetaminophen in moderate-to-severe pain following the surgical removal of impacted third molars. Participants (n = 212) were given naproxen sodium, hydrocodone plus acetaminophen, or placebo and were evaluated over twelve hours.
In this placebo-controlled, single-center, double-blind study, the summed pain intensity difference from 0 to twelve hours (SPID0-12) was the major outcome while Pain relief, duration of pain at least half gone, pain intensity, and time to rescue medication were the secondary outcomes. Adverse events, the onset of pain relief, and global evaluation of treatment were the other outcomes ascertained.
Both active therapies showed superior efficacy when compared to placebo. In terms of SPID0-12, total pain relief (0-6 and 0-12 hours), duration of pain at least half gone, and time to rescue medication, naproxen sodium displayed better efficacy when compared to hydrocodone plus acetaminophen.
Regarding the outcomes of the study, hydrocodone plus acetaminophen was not superior to naproxen sodium. More adverse events were noted with hydrocodone plus acetaminophen (n = 63) compared to placebo (n = 20) and naproxen sodium (n = 2), including dizziness, nausea, and vomiting.
The Postgraduate Medical Journal
Analgesic efficacy of naproxen sodium versus hydrocodone/acetaminophen in acute postsurgical dental pain: a randomized, double-blind, placebo-controlled trial
Stephen A Cooper et al.
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