Onset and duration of analgesia for low-dose ketoprofen in the treatment of postoperative dental pain

The objective of this single dose, double-blind study was to determine the relative analgesic efficacy of low-dose ketoprofen (6.25 mg, 12.5 mg and 25 mg? compared with ibuprofen (200 mg) and placebo in 175 patients with mode rate to severe postoperative pain secondary to extraction of impacted third molars. Analgesia was measured during the B-hour period after administrati on based on onset of relief, hourly and summary variables, and duration of treatment effect. All active treatments were significantly more effective t han placebo for many hourly measures and for the summary measures sum of pa in intensity differences (SPID), sum of hourly pain relief values (TOTPAR), time to peak pain relief, and patient global assessment of study medicatio n. The three ketoprofen doses were significantly more effective than placeb o beginning at 30 minutes, whereas ibuprofen was significantly better than placebo beginning at 1 hour. A dose-response relationship was observed for ketoprofen, with the two higher doses providing significantly greater analg esia than the lower dose. However, a plateau effect was seen between the 12 .5-mg and 25-mg dose levels. A significantly greater proportion of patients treated with each of the active treatments (ranging from 0.83 to 0.88) rep orted onset of relief compared with placebo (0.20). The distribution functi ons of onset of relief differed significantly among treatments, with ketopr ofen 12.5 mg and 25 mg having a faster onset than ibuprofen 200 mg and keto profen 6.25 mg. The duration of effect was generally shorter)cor ketoprofen than for ibuprofen, and these difference were significant. This study prov ides evidence that at the dose levels of 12.5 mg and 25 mg ketoprofen is an effective analgesic in providing relief of postoperative dental pain. Keto profen 12.5 mg and 25 mg provide significantly greater relief in the earlie r time period, with a faster onset and shorter duration of effect than ibup rofen 200 mg. The two higher doses of ketoprofen provided similar analgesia , and no additional benefit was obtained by increasing the dose of ketoprof en to 25 mg. Therefore, we conclude that ketoprofen 12.5 mg is an appropria te dose for over-the-counter use. (C) 1998 The American College of Clinical Pharmacology.