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Opioids for pain after oral surgery
Author(s) -
Patel N.,
Bailey E.,
Coulthard P.
Publication year - 2014
Publication title -
oral surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.156
H-Index - 11
eISSN - 1752-248X
pISSN - 1752-2471
DOI - 10.1111/ors.12076
Subject(s) - medicine , analgesic , codeine , morphine , anesthesia , number needed to treat , acetaminophen , confidence interval , relative risk
Aim To describe the role of opioids in the management of pain after oral surgery. Materials and methods A review of the literature describing the pharmacokinetics, benefits and harms of opioids in terms of systematic review evidence, interactions, use in children, pregnancy and breastfeeding. Results A 10‐mg intramuscular dose of morphine is recognised as a very effective analgesic for post‐operative pain with a number needed to treat ( NNT ) of 2.9. Codeine 60 mg has an NNT of 16.7 suggesting poor analgesic effectiveness, but in combination with 1 g paracetamol is an effective analgesic for the management of post‐operative pain with an NNT of 2.2. Conclusions Morphine is effective for severe pain experienced by inpatients undergoing oral surgery, ideally administered intravenously or alternatively by intramuscular injection. Codeine is very effective when combined with paracetamol and is suitable for day‐case and outpatient oral surgery experiencing moderate to severe pain.