Comparison of ibuprofen and acetaminophen with codeine following cosmetic facial surgery.
OBJECTIVE
To compare the efficacy and side effects of ibuprofen and acetaminophen with codeine when given postoperatively following cosmetic facial surgery and to assess whether bruising is worse or the incidence of hematoma is greater when ibuprofen is taken postoperatively.


METHODS
Prospective, double-blind, randomized trial.


METHODS
Accredited outpatient surgery centre.


METHODS
Study subjects received scheduled doses of either oral ibuprofen 400 mg or acetaminophen/codeine 600/60 mg four times a day through postoperative day 3. They recorded their pain level on a 10 cm visual analogue scale, as well as any untoward side effects, at scheduled times throughout the first 3 postoperative days. Severity of bruising was assessed on postoperative day 4. Any postoperative hematomas were managed and recorded.


RESULTS
There was no significant difference in pain relief or average bruising scores between the two groups. Subjects receiving ibuprofen had significantly fewer adverse side effects and were less likely to change medications than those receiving acetaminophen with codeine. None of the patients in either group developed a postoperative hematoma.


CONCLUSIONS
Ibuprofen 400 mg is as effective as acetaminophen/codeine 600/60 mg for pain relief following cosmetic facial surgery. Ibuprofen is better tolerated, with fewer side effects, than acetaminophen with codeine. Ibuprofen given postoperatively does not result in increased bruising or increased incidence of hematoma.
Chen
Theodore
T
Department of Head and Neck Surgery, Southern California Permanente Medical Group, Los Angeles, California, USA. mrtheodore@yahoo.com
Adamson
Peter A
PA
D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use*; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D003061:Codeine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005145:Face / Q000601:surgery; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D013518:Surgery, Plastic; D016896:Treatment Outcome
D000700:Analgesics; D000082:Acetaminophen; D003061:Codeine; D007052:Ibuprofen