The purpose of this research study is to find out if taking Acetaminophen with Ibuprofen (e.g. Tylenol + Advil), a non-opioid regimen, provides the same type of pain relief after hand surgery compared to Acetaminophen and codeine (e.g. Tylenol 3), an opioid regimen.

Primary Objective:

To establish, through a randomized control trial, whether post-operative Acetaminophen and Ibuprofen (non-opioid regimen) would provide equivalent post-operative analgesia to ambulatory hand surgery patients compared to Acetaminophen and Codeine (opioid regimen).

Secondary Objective:

To establish whether the opioid versus non-opioid post-operative pain regimen influences patient satisfaction.

Sixty-three patients enrolled for each group (non-opioid and opioid). Approximately 145 patients will be required to achieve complete data for 63 patients in each group (assuming 15% lost to follow-up & failure to comply with study protocol).

Inclusion Criteria:

• Patients undergoing ambulatory hand surgery for carpal tunnel and trigger finger, under local anesthesia with or without sedation.

Exclusion Criteria:

• ASA> 3;
• Coagulopathy;
• Renal disease,
• Liver disease,
• History of recent gastro-intestinal bleeding
• Pregnancy.
• Diagnosis of chronic pain currently taking opioid pain medication or with a history of drug abuse.
• Patients with a self-described allergy to ASA, acetaminophen, NSAIDS and codeine.
• All patients receiving a brachial plexus block for anesthesia and/or analgesia

144 patients were consented for this study. There were 4 patients that were enrolled but did not make it to the randomization stage and 140 patients were placed into the study. 111 patients completed the study and were included in analysis.

Adverse events were collected for the subjects time participating on the study. Participation began on the subject's surgery day and ended at their first clinical visit (6-8 days after surgery).