Time to Onset of Analgesia and Analgesic Efficacy of Effervescent Acetaminophen 1000 mg Compared to Tablet Acetaminophen 1000 mg in Postoperative Dental Pain: A Single‐Dose, Double‐Blind, Randomized, Placebo‐Controlled Study

Abstract

This randomized, double-blind, placebo-controlled study compared the time to onset of analgesia and the analgesic efficacy of two formulations of acetaminophen 1000 mg--an effervescent solution and tablet--in 242 patients with moderate or severe pain following dental surgery. Onset of analgesia was determined using a two-stopwatch procedure. Analgesia was assessed over a 4-hour period. Treatments were compared using standard indexes of pain intensity and pain relief and summary measures. Both acetaminophen formulations were significantly more effective than their corresponding placebo for all efficacy assessments. The median time to onset of analgesia was significantly shorter with effervescent acetaminophen (20 minutes) compared to tablet acetaminophen (45 minutes). During the first 45 minutes after administration, effervescent acetaminophen was significantly more effective at each scheduled assessment time than tablet acetaminophen. The median time to meaningful pain relief was significantly shorter with effervescent acetaminophen (45 minutes) compared to tablet acetaminophen (60 minutes). At 4 hours after administration, the pain relief was significantly better with tablet acetaminophen than with effervescent acetaminophen. No other significant differences were observed between the active treatments. In conclusion, effervescent acetaminophen produces a significantly faster onset of analgesia than tablet acetaminophen.

Early bioavailability of paracetamol after oral or intravenous administration

“…It has been demonstrated that bicarbonate formulations of paracetamol are absorbed faster than ordinary tablets (14,17). The time to analgesic onset has been shown to vary between different formulations with a slower onset for ordinary tablets (18). We could not see any major difference in plasma concentration pattern between the two formulations of oral paracetamol studied, but the low number of patients and sample times should of course be considered.…”

Lack of a pre-emptive effect of low-dose ketamine on postoperative pain following oral surgery

“…No patient required nalbuphine in the ambulatory care unit. There was no difference between groups with respect to the number of rescue analgesic tablets required at home: 6 (2,13), 7 (2,20), and 7 (1,12) for Groups 1, 2, and 3 respectively. The mean times to first request for rescue analgesic medication were similar amongst groups ( Figure 1), as were VAS pain scores measured in the PACU and in the ambulatory care unit (Figure 2).…”

“…Postoperative pain after surgical removal of third molar was selected because it is a robust and reliable pain model that has been widely used by investigators, 19,20 and because it is widely performed in our institution on an outpatient basis with adequate pain control.…”

Comparison of a novel fast-dissolving acetaminophen tablet formulation (FD-APAP) and standard acetaminophen tablets using gamma scintigraphy and pharmacokinetic studies

“…Many attempts have been made to improve the rate of onset of activity of acetaminophen. For example, soluble tablets have been shown to have a quicker rate of absorption 21 and a faster onset of analgesic action compared with conventional acetaminophen tablets 22 . However, soluble tablets are not always convenient as they have to be dissolved in water prior to administration, and moreover acetaminophen-containing solutions are unpalatable to some patients.…”