have decided to perform a systematic review on all randomized trials where the association paracetamol/NSAIDs has been compared with the
drugs alone in controlling postoperative pain. The trial was sponsoredby the producer of tablets containing paracetamol and ibuprofen. The examined randomized trials, comparing the association with paracetamol,have been only 20, with an overall sample of 1852 patients. In 16 trials (80%), the combination of analgesics has been more effective than
paracetamol alone for at least one of the three considered parameters(pain score, need to use a supplementary analgesic, relief of pain judged through complex evaluation): the average reduction of pain
intensity has been of 35% and the reduction of the request for further analgesia has been of 39%. 14 trials involving 129 patients have assessed the efficacy of an analgesic combination compared to the use of
a NSAID alone: in 9 trials (64%), it was shown that the association was better than the NSAID alone, with an average reduction of 38% in pain intensity and a reduction of 31% in the request for further analgesia.
The incidence of side effects has not recorded any significant differences between the drug alone and the association.
According to this trial, adding a NSAID to paracetamol, physicians succeed in improving the control of
postoperative pain, at least in the considered cases (orthopedic,gynecological, dental and otolaryngoiatric surgery).
