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1.  Efficacy of Low Dose Combination Analgesics: Acetaminophen/Codeine, Aspirin/Butalbital/Caffeine/Codeine, and Placebo in Oral Surgery Pain 
Anesthesia Progress  1986;33(3):143-146.
A double-blind, randomized, single-dose study was performed to compare the efficacy and safety of two commonly prescribed combination analgesic products to placebo. The combinations were acetaminophen 300 mg/codeine 30 mg†, and aspirin 325 mg/butalbital 50 mg/caffeine 40 mg/codeine 30 mg††. One hundred twenty-three (123) oral surgery outpatients took study medications when their pain became moderate to severe and recorded the levels of pain intensity, pain relief, anxiety and relaxation at 30 minutes and hourly for 6 hours after dosing. Remedication was permitted if study medications did not provide adequate pain relief. Time to remedication, and the number of observations with 50% or better relief, were noted as were any side effects. An overall evaluation was obtained from each patient. Results of the study showed that the aspirin/butalbital/caffeine/codeine combination was significantly more effective than placebo for total pain relief, peak relief and global evaluation. While the acetaminophen/codeine combination was numerically superior to placebo, it achieved statistical significance only for global evaluation. The aspirin/butalbital/caffeine/codeine combination was numerically superior to acetaminophen/codeine for every measure of analgesic efficacy but the differences did not achieve statistical significance. Both active treatment groups experienced significantly less total anxiety than did the placebo group. Only 11 patients reported mild, transient adverse effects; the most common was drowsiness. The adverse effects occurred equally among the three treatment groups. In this study, the aspirin/butalbital/caffeine/codeine combination was significantly superior to placebo and somewhat better than acetaminophen/codeine.
PMCID: PMC2175477  PMID: 3461726
2.  Measurement of Meperidine Induced Respiratory Depression Using a New Non-Invasive Technique 
Anesthesia Progress  1985;32(5):194-198.
Inductive plethysmography was used to assess the magnitude and duration of respiratory depression caused by doses of meperidine commonly administered during dental intravenous sedation. Minute volume measurements exhibited a high degree of accuracy when compared to simultaneous spirometry. Intravenously administered meperidine 25 mg/70 kg and 50 mg/70 kg both caused a significant shift to the right in their respective ventilatory-pco2 response curves. The magnitude and duration of this respiratory depression was dose related. Even relatively low doses of meperidine used in dental intravenous sedation cause respiratory depression.
PMCID: PMC2175416  PMID: 3866502

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