Acetylsalicylic acid vs paracetamol: Effects on post-operative course

Summary

Acetylsalicylic acid(ASA) was compared with paracetamol(P) in a double-blind crossover study, in which essentially the same operation was performed on two separate occasions in 32 healthy patients, who required surgical removal of bilateral “identically” impacted wisdom teeth. Sixteen patients were given the drugsboth before andafter(b & a-group) the operations (0.5 g on the pre-operative evening, followed by 0.5 g × 4 for 3 days); the other 16 patients did not start treatment until 2 hoursafter(a-group) the operations. A number of objective and subjective factors were assessed, including swelling, bleeding, pain and preference, and were used to make comparisons of the pre-, per-and post-operative courses. About 50% greater post-operative swelling was associated withASA compared toP, either if medication was begun prior to surgery or if the drugs were given only after operation. In theb & a-group, interference with platelet function and prolonged pre-operative bleeding time were produced byASA (8.9 vs 6.5 min), but the per-operative blood loss was not significantly increased (7.8 vs 7.4 ml). In both groupsASA tended to increase post-operative bleeding and the formation of haematomas and ecchymoses. There was no noticeable difference betweenASA andP with respect to pain score, but the preference scores showed a tendency to favourP in both groups. It appears that in circumstances with acute tissue injuries,P should be preferred toASA, if post-traumatic swelling and bleeding are to be prevented or reduced.