A comparative analysis of paracetamol, ibuprofen, and their combined administration in the management of post-endodontic pain

Summary:
This randomized, placebo-controlled, single-blind study evaluated the effectiveness of paracetamol, ibuprofen, and their combination in managing pain after endodontic treatment among 80 patients divided into four groups. Pain intensity was measured at multiple intervals up to six hours using a Numerical Rating Scale and analyzed statistically at a 95% confidence level. Results showed that paracetamol provided significantly greater pain relief than ibuprofen, the combination therapy, and placebo within the first two hours, while the combined regimen offered better relief than ibuprofen alone, though not at a statistically significant level. 

Pain following endodontic therapy is commonly observed, even though the procedure is intended to relieve persistent discomfort. Non-opioid analgesic medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol, are routinely used to manage pain. This randomized, placebo-controlled, single-blind trial evaluated the effectiveness of paracetamol, ibuprofen, and their combined administration in controlling post-endodontic pain.

Eighty individuals who underwent endodontic instrumentation were randomly allocated into four groups (n = 20 per group): paracetamol, ibuprofen, paracetamol combined with ibuprofen, and placebo. Pain levels were measured using a Numerical Rating Scale (NRS) at baseline (0 hour) and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, and 6 hours after medication intake. Data were analyzed using Friedman’s test followed by Kruskal–Wallis H post-hoc analysis. A p value of less than 0.05 was considered statistically significant at a 95% confidence interval.

During the initial two hours after drug administration, paracetamol produced significantly greater pain reduction than ibuprofen, the combined regimen, and placebo (p < 0.05). Although the combination of paracetamol and ibuprofen resulted in superior pain control compared with ibuprofen alone within the same timeframe, the difference was not statistically significant (p > 0.05).