title: The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To run a systematic review and meta-analysis of randomized clinical trials aiming to answer the clinical question "which analgesic combination and dosage is potentially the most effective and safe for acute post-operative pain control after third molar surgery?".
  
  
  METHODS
  A systematic search of computer databases and journals was performed. The search and the evaluations of articles were performed by 2 independent reviewers in 3 rounds. Randomized clinical trials related to analgesic combinations for acute post-operative pain control after lower third molar surgery that matched the selection criteria were evaluated to enter in the final review.
  
  
  RESULTS
  Fourteen studies with 3521 subjects, with 10 groups (17 dosages) of analgesic combinations were included in the final review. The analgesic efficacy were presented by the objective pain measurements including sum of pain intensity at 6 hours (SPID6) and total pain relief at 6 hours (TOTPAR6). The SPID6 scores and TOTPAR6 scores of the reported analgesic combinations were ranged from 1.46 to 6.44 and 3.24 - 10.3, respectively. Ibuprofen 400mg with oxycodone HCL 5mg had superior efficacy (SPID6: 6.44, TOTPAR6: 9.31). Nausea was the most common adverse effect, with prevalence ranging from 0-55%. Ibuprofen 200mg with caffeine 100mg or 200mg had a reasonable analgesic effect with fewer side effects.
  
  
  CONCLUSIONS
  This systematic review and meta-analysis may help clinicians in their choices of prescribing an analgesic combination for acute post-operative pain control after lower third molar surgery. It was found in this systematic review Ibuprofen 400mg combined with oxycodone HCL 5mg has superior analgesic efficacy when compared to the other analgesic combinations included in this study.
authors.affiliation: Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People Republic of China.
authors.forename: Alvin Ho Yeung
authors.initials: AH
authors.lastname: Au
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People Republic of China.
authors.forename: Siu Wai
authors.initials: SW
authors.lastname: Choi
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People Republic of China.
authors.forename: Chi Wai
authors.initials: CW
authors.lastname: Cheung
authors.affiliation: Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People Republic of China.
authors.forename: Yiu Yan
authors.initials: YY
authors.lastname: Leung
mesh_terms: D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D008964:Molar, Third / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D004338:Drug Combinations