Forbes J A, Kehm C J, Grodin C D, Beaver W T
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pharmacotherapy. 1990;10(6 ( Pt 2)):94S-105S.
Two-hundred six outpatients with postoperative pain after the surgical removal of impacted third molars were randomly assigned on a double-blind basis to receive oral doses of ketorolac tromethamine 10 and 20 mg, ibuprofen 400 mg, acetaminophen 600 mg, a combination of acetaminophen 600 mg plus codeine 60 mg, or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 6 hours after medicating. All active medications were significantly superior to placebo. Analgesia was similar for ketorolac 10 and 20 mg and ibuprofen 400 mg; however, these treatments were superior to acetaminophen alone and the acetaminophen-codeine combination. The analgesic effect of each active medication was significant by hour 1 and persisted for 5-6 hours. The data suggest a plateau in ketorolac's analgesic efficacy at the 10-mg level. Repeat-dose data indicated that on the day of surgery ketorolac 10 and 20 mg and ibuprofen 400 mg were superior to acetaminophen 600 mg; ketorolac 20 mg was also superior to acetaminophen-codeine. Differences among active medications were not significant when data for the entire postoperative period (days 0-6) were evaluated. The frequency of adverse effects was similar for the active medications.
206名拔除阻生第三磨牙后出现术后疼痛的门诊患者被随机双盲分组，分别口服10毫克和20毫克酮咯酸氨丁三醇、400毫克布洛芬、600毫克对乙酰氨基酚、600毫克对乙酰氨基酚加60毫克可待因的组合制剂或安慰剂。用药后，受试者使用自评记录，每小时对疼痛及其缓解情况进行评分，共持续6小时。所有活性药物均显著优于安慰剂。10毫克和20毫克酮咯酸以及400毫克布洛芬的镇痛效果相似；然而，这些治疗优于单独使用对乙酰氨基酚以及对乙酰氨基酚 - 可待因组合制剂。每种活性药物在第1小时时镇痛效果显著，并持续5 - 6小时。数据表明酮咯酸在10毫克剂量水平时镇痛效果达到平稳状态。重复给药数据表明，在手术当天，10毫克和20毫克酮咯酸以及400毫克布洛芬优于600毫克对乙酰氨基酚；20毫克酮咯酸也优于对乙酰氨基酚 - 可待因。评估整个术后期间（第0 - 6天）的数据时，活性药物之间的差异不显著。活性药物的不良反应发生率相似。
