| JOURNAL HOME | CME HOME | THIS MONTH | PAST ISSUES | ETOC | COLLECTIONS |
| AUTHORS | REVIEWERS | EDITORIAL BOARD | FEEDBACK | RSS | HELP |
| ||||||||||||||
| ||||||||||||||
|
|
|
|
||||||||||||
|
||||||||||||||
*University of Tel Aviv, Faculty of Medicine, Israel; and
Division of Analgesic, Antiinflammatory, and Ophthalmic Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, Maryland
Address correspondence and reprint requests to Meyer Katzper, PhD, Division of Analgesic, Antiinflammatory, and Ophthalmic Drug Products, HFD-550, Center for Drug Evaluation and Research, Food and Drug Administration, 2 Locks Pond Court, Rockville, MD 20854. Address e-mail to katzper{at}cder.fda.gov
The purpose of this study was to determine whether different levels of pain would respond similarly to analgesia. We compared the analgesic response to ibuprofen in subjects with moderate versus severe baseline pain in clinical trials using the third molar post-extraction dental pain model. We performed a pooled raw data analysis of 517 subjects included in the ibuprofen treatment arm of 11 similar studies submitted to the Food and Drug Administration. The inclusion and exclusion criteria were similar in all studies. All studies used the same metrics and recorded pain at the same times. As expected, the well established analgesic effect of ibuprofen was confirmed. More intense baseline pain was initially associated with a larger decrease and greater fractional decreasing in pain intensity after medication. A larger percentage of those with milder baseline pain obtained relief compared with those with severe baseline pain. Reduction in pain intensity occurred mainly in the first 2 h. At later time points, the association of baseline conditions with a reduction in pain level diminished. We conclude that the intensity of initial pain is not correlated with the need for larger doses of analgesic.
IMPLICATIONS: A person taking an analgesic wants to know when and how well it will work. People with moderate pain are more likely to get relief, whereas those with severe pain who get relief will get relatively more relief. Most relief of acute pain occurs within less than 2 h. These data indicate that most people with intense initial pain do not require larger doses of analgesics.
This article has been cited by other articles:
|
|
 |
|
  A. Gray, H. Kehlet, F. Bonnet, and N. Rawal Predicting postoperative analgesia outcomes: NNT league tables or procedure-specific evidence? Br. J. Anaesth., June 1, 2005; 94(6): 710 - 714. [Abstract] [Full Text] [PDF]
|
|
|
