You do love the edge cases. Yes there are potential serious side effects with ibuprofen and acetaminophen but those people do make make up the majority of prescriptions written for opioids any more than end of life treatment does.
I can tell you why Percocet and Norco are still in the billion dollar range for annual sales because patients push their doctors to prescribe them (in case you missed it they are addictive, even a mouse pushes whatever they are asked to push to keep them flowing) and because of physicians not willing to refuse to prescribe them for people who can safely take available alternatives.
The fact that these studies have been widely available so long and few are aware of it is simply sad.
As to the references so many relate to dental because that is where most very healthy people first got exposed to opioids. I remember getting a heap of them when I got my wisdom teeth out. Thankfully I haven't gotten an opioid prescription for a dental procedure in years. That group has figured it out.
As I am sure you know the ability to publish is based on whether a publication is producing new information. Since it was established years ago that the combo works in a general sense, the way to get published now is to drill down to specific situations. So now the publications describe specific application areas where the combo works well. Below I provided a brief list of recent publications documenting effectiveness in non-dental procedures.
Annals of Surgical Oncology (2021)
Just Say No: The Case Against Opioid-Based Postoperative Pain Management Regimens Following Breast Surgery
Patient Satisfaction With Nonopioid Pain Management Following Arthroscopic Partial Meniscectomy and/or Chondroplasty
Arthroscopy: The Journal of Arthroscopic & Related Surgery (2019)
Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency DepartmentA Randomized Clinical Trial
JAMA (2017)
As for google, it provides excellent results for discerning users. Above is from google. The article below is the number one publication returned from 'Pubmed' for a search for "replacing opioids with ibuprofen and acetaminophen". FYI, PubMed is also only as good as the person using.
"Effect of Combination of Paracetamol and Ibuprofen vs Either Alone on Patient-Controlled Morphine Consumption in first 24 hours after total hip arthroplasty: The PANSAID Randomized Clinical trial", JAMA:Feb 2019.
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