Paracetamol versus placebo: effects on post-operative course.

Paracetamol was compared with placebo in a double-blind crossover study, in which essentially the same operation was performed on two separate occasions in 24 healthy patients, namely surgical removal of bilateral impacted wisdom teeth. Commencing on the day of surgery, either paracetamol (Panodil; 1.0 g x 4 for 2 days, then 0.5 g x 4 for the next 2 days) or placebo tablets were given, followed by crossover to the alternative treatment at the second operation about 4 weeks later. Several objective and subjective assessments were recorded for paired comparison of post-operative courses. Swelling on the 3rd day after operation when paracetamol was given averaged 71% of that measured when placebo was given (p less than 0.05). After paracetamol, a tendency was noted towards reduced local hyperpyrexia and less post-operative bleeding. The pain and preference scores were clearly in favour of paracetamol. The results provide evidence to suggest that paracetamol may reduce an acute, posttraumatic inflammatory reaction.