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MBlume comments on Not Technically Lying - Less Wrong
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Perhaps I'm just arguing for the conclusion I want, and thus digging myself deeper, but in your example, 3 seems entirely truthful to me. You're administering saline, sure, but you're administering it in order to treat pain. If you had a better means of treating pain, you would be using that. Given those circumstances "The strongest painkiller I have." actually seems accurate.
It is truth, but you are explicitly saying those words so that the hearer (the patient) forms a false belief about the world. So it cannot be really truthful because most people in that situation would, after hearing example 3, believe that they are being given something that has more affect than a placebo.