Objectives: The aim of this study was to assess the preemptive analgesic efficacy of ibuprofen 400 mg combined with paracetamol 500 mg after lower third molar surgery.

Methods: A randomized double-blinded controlled clinical trial was conducted. Patients were randomized into the preemptive group (ibuprofen 400 mg combined with paracetamol 500 mg) and the control group (placebo) using block randomization. Preemptive drugs and the placebo were administered to patients orally 1 hour before undergoing lower third molar surgery. The following outcomes were assessed: postoperative pain assessed with visual analog scale (VAS), number of patients who received rescue medications, number of pain-free patients, time at first requirement for rescue medications, number of patients who received rescue medications, and drug satisfaction.

Results: The 48 patients were randomized, 24 to the control group and 24 to the preemptive group. The time until first requirement for rescue medications in the preemptive group was significantly longer than that of the control group (p=0.003). The other outcomes were not significantly different between groups.

Conclusions: Preemptive ibuprofen 400 mg combined with paracetamol 500 mg did not reduce postoperative pain after lower third molar surgery; however, the preemptive therapy delayed the time required for rescue medications.