Tenoxicam and paracetamol-codeine combination after oral surgery: a prospective, randomized, double-blind, placebo-controlled study

We studied 90 adults undergoing surgical removal of at least both lower thi rd molar teeth as day cases under standardized general anaesthesia. Patient s were allocated randomly (with stratification for surgeon) to receive teno xicam 40 mg, tenoxicam 20 mg or placebo i.v. at induction of anaesthesia an d orally (effervescent tablets) with food on each of the subsequent 2 days. Panadeine (paracetamol 500 mg-codeine 8 mg) was given before operation and was available as needed for pain thereafter, to a limit of two tablets eve ry 4 h. Nefopam i.v. was also available. Efficacy variables and adverse rea ctions were assessed over 6 days. Over the 6-day period, patients who recei ved tenoxicam reported less pain on rest (area under the curve; P<0.05) and less disturbance in sleep (P<0.01) even though they used fewer Panadeine t ablets (P<0.05). Differences between tenoxicam 40 mg and 20 mg were not sig nificant. There was no significant difference in nefopam requirements or si de effects, and no adverse event attributable to the study medication.