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This is also partly because more recent studies have determined that for important types of post-surgical pain of this sort, combination ibuprofen+acetaminophen
by dgacmu 7y ago
This is also partly because more recent studies have determined that for important types of post-surgical pain of this sort, combination ibuprofen+acetaminophen is actually more effective than hydrocodone.
https://www.aafp.org/afp/2018/0301/p348.html https://www.aafp.org/afp/2018/0301/p348.html
is one example, for patients presenting in the ER with extremity pain, and one that's specific to impacted wisdom tooth extraction is:
https://www.ncbi.nlm.nih.gov/pubmed/28586638 https://www.ncbi.nlm.nih.gov/pubmed/28586638
("CONCLUSION: Codeine 60 mg added to a regimen of paracetamol 1,000 mg and ibuprofen 400 mg does not improve analgesia after third molar surgery.")
There's a study I'm very curious to see the results of for this question for post-caesarian patients: https://clinicaltrials.gov/ct2/show/NCT03372382 https://clinicaltrials.gov/ct2/show/NCT03372382
(study is still underway).
And there's been really promising results for other forms of post-surgical pain management. One great example is the use of a QL nerve block administered during surgery to manage post-caesarian pain:
https://sci-hub.tw/https://rapm.bmj.com/content/early/2019/10/24/rapm-2019-100752 https://sci-hub.tw/https://rapm.bmj.com/content/early/2019/1...
"QL block has been associated with reduced postoperative opioid consumption and pain scores in patients undergoing cesarean delivery, [... but more study is needed because the studies weren't big/comprehensive enough ...]"
There are lots of caveats here (in other words, don't believe some random schmuck on the Internet over your doctor) -- different types of pain may respond differently, different people may respond differently, etc., etc. Ibuprofen impairs clotting and is inappropriate for use with some patients and some types of injury. Acetaminophen has to be dosed carefully to avoid liver toxicity. No free lunch. But it's certainly promising from the perspective of non-narcotic pain treatment _in some circumstances_.
(Please don't misconstrue what I'm saying, of course, as suggesting we can or should eliminate opiates. There's a place for everything in our arsenal. But there's been a lot of progress in the last decade that open up alternatives in some cases.)
Glossary, in case it's helpful: acetaminophen (US) = paracetamol (UK) = tylenol (brand name). ibuprofen = motrin = advil. oxycodone/acetaminophen = percoset (brand name; ratios may vary).
- true_religion 7y agoHaving been on both, I can say personally hydrocodone seemed more effective.
- rebeccaskinner 7y agoMy anecdotal data says the opposite. I've been prescribed opioid pain killers (Codeine/acetaminophen and Tramadol) a few different times (post regular and oral surgery, after a particularly nasty wrist and ankle sprain, and most recently after getting some second degree burns from a cooking accident). The first couple of times I was prescribed them I remember thinking how bad the pain must have been to have still felt so intense after taking opioids- but eventually I realized that the prescribed opioid pain killers were just not doing much to help at all, and Ibuprofen was far more effective for me. These days I don't even bother filling the prescription and just go straight to advil to manage pain. I'm certainly not well educated in medicine, so it's hard to say whether my experiences can be generalized to the broader population, but if my experiences are at all common it does make me wonder why the are so broadly prescribed, and why I was never advised to even try NSAIDs before escalating to opioids with their associated side effects and addiction risk.
- deleted 7y ago[deleted]