pubmed.ncbi.nlm.nih.gov

Single dose oral ketoprofen or dexketoprofen for acute postoperative pain in adults - PubMed

  • ️Sun Jan 01 2017

Review

Single dose oral ketoprofen or dexketoprofen for acute postoperative pain in adults

Helen Gaskell et al. Cochrane Database Syst Rev. 2017.

Abstract

Background: This review is an update of "Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults" last updated in Issue 4, 2009. Ketoprofen is a non-selective nonsteroidal anti-inflammatory drug (NSAID) used to treat acute and chronic painful conditions. Dexketoprofen is the (S)-enantiomer, which is believed to confer analgesia. Theoretically dexketoprofen is expected to provide equivalent analgesia to ketoprofen at half the dose, with a consequent reduction in gastrointestinal adverse events. This review is one of a series on oral analgesics for acute postoperative pain. Individual reviews have been brought together in two overviews to provide information about the relative efficacy and harm of the different interventions.

Objectives: To assess the efficacy and safety of single dose oral ketoprofen and oral dexketoprofen compared with placebo for acute postoperative pain, using methods that permit comparison with other analgesics evaluated in the same way, and criteria of efficacy recommended by an in-depth study at the individual patient level.

Search methods: For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase from 2009 to 28 March 2017. We also searched the reference lists of retrieved studies and reviews, and two online clinical trial registries.

Selection criteria: Randomised, double-blind, placebo-controlled trials of single dose orally administered ketoprofen or dexketoprofen in adults with moderate to severe acute postoperative pain.

Data collection and analysis: Two review authors independently considered studies for inclusion in the review, examined issues of study quality and potential bias, and extracted data. For dichotomous outcomes, we calculated risk ratio (RR) and number needed to treat for an additional beneficial outcome (NNT) or harmful outcome (NNH) with 95% confidence intervals (CI) for ketoprofen and dexketoprofen, compared with placebo, where there were sufficient data. We collected information on the number of participants with at least 50% of the maximum possible pain relief over six hours, the median time to use of rescue medication, and the proportion of participants requiring rescue medication. We also collected information on adverse events and withdrawals. We assessed the quality of the evidence using GRADE, and created 'Summary of findings' tables.

Main results: This updated review included 24 studies; six additional studies added 1001 participants involved in comparisons of ketoprofen or dexketoprofen and placebo, with a 12% increase in participants taking ketoprofen and a 65% increase for dexketoprofen. Most participants (70%) were women. Dental studies typically involved young participants (mean age 20 to 30 years); other types of surgery involved older participants (mean age 37 to 68 years). Overall, we judged the studies at high risk of bias only for small size, which can lead to an overestimation of benefit.Ketoprofen doses ranged between 6.5 mg and 150 mg. The proportion of participants achieving at least 50% pain relief over six hours with the usual ketoprofen oral dose of 50 mg was 57%, compared to 23% with placebo, giving an NNT of 2.9 (95% CI 2.4 to 3.7) (RR 2.5, 95% CI 2.0 to 3.1; 594 participants; 8 studies; high quality evidence). Efficacy was significantly better in dental studies (NNT 1.8) than other surgery (NNT 4.2). The proportion of participants using rescue medication within six hours was lower with ketoprofen (32%) than with placebo (75%), giving a number needed to treat to prevent use of rescue medication (NNTp) of 2.3 (95% CI 1.8 to 3.1); 263 participants; 4 studies; high quality evidence). Median time to remedication estimates were poorly reported. Reports of any adverse event were similar with ketoprofen (18%) and placebo (11%) (RR 1.6, 95% CI 0.98 to 2.8; 342 participants; 5 studies; high quality evidence). No study reported any serious adverse events (very low quality evidence).Dexketoprofen doses ranged between 5 mg and 100 mg. The proportion of participants achieving at least 50% pain relief over six hours with the usual dexketoprofen oral dose of 20 mg or 25 mg was 52%, compared to 27% with placebo, giving an NNT of 4.1 (95% CI 3.3 to 5.2) (RR 2.0, 95% CI 1.6 to 2.2; 1177 participants; 8 studies; high quality evidence). Efficacy was significantly better in dental studies (NNT 2.7) than other surgery (NNT 5.7). The proportion of participants using rescue medication within six hours was lower with dexketoprofen (47%) than placebo (69%), giving an NNTp of 4.7 (95% CI 3.3 to 8.0); 445 participants; 5 studies; high quality evidence). Median time to remedication estimates were poorly reported. Reports of any adverse event were similar with dexketoprofen (14%) and placebo (10%) (RR 1.4, 95% CI 0.89 to 2.2; 536 participants, 6 studies; high quality evidence). No study reported any serious adverse events (very low quality evidence).

Authors' conclusions: Ketoprofen at doses of 25 mg to 100 mg is an effective analgesic in moderate to severe acute postoperative pain with an NNT for at least 50% pain relief of 2.9 with a 50 mg dose. This is similar to that of commonly used NSAIDs such as ibuprofen (NNT 2.5 for 400 mg dose) and diclofenac (NNT 2.7 for 50 mg dose). Dexketoprofen is also effective with an NNT of 4.1 in the dose range 10 mg to 25 mg. Differential efficacy between dental surgery and other types of surgery seen for both drugs is unusual. Both drugs were well tolerated in single doses.

PubMed Disclaimer

Conflict of interest statement

HG: none known; HG is a retired geriatrician and has treated patients with acute pain.

SD: none known.

PW: none known.

RAM is an author of three of the included trials. He has received grant support from Grünenthal relating to individual patient level analyses of trial data regarding tapentadol in osteoarthritis and back pain (2015). He has received honoraria for attending boards with Menarini concerning methods of analgesic trial design (2014), with Novartis (2014) about the design of network meta‐analyses, and RB on understanding pharmacokinetics of drug uptake (2015). He has received honoraria from Omega Pharma (2016) and Futura Pharma (2016) for providing advice on trial and data analysis methods.

Figures

1
1

Study flow diagram.

2
2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

3
3

Forest plot of comparison: 3 Ketoprofen 50 mg versus placebo, outcome: 3.1 Participants with at least 50% pain relief over four to six hours.

4
4

Ketoprofen 50 mg: percent of participants with at least 50% pain relief over four to six hours. Size of circle is proportional to size of study (inset scale). Dental studies: yellow; bunionectomy study: dark blue; other non‐dental studies: light blue.

5
5

Forest plot of comparison: 6 Dexketoprofen 20 mg or 25 mg versus placebo, outcome: 6.1 Participants with at least 50% pain relief over four to six hours.

6
6

Dexketoprofen 20/25 mg: percent of participants with at least 50% pain relief over four to six hours. Size of circle is proportional to size of study (inset scale). Dental studies: yellow; bunionectomy study: dark blue; other non‐dental studies: light blue.

1.1
1.1. Analysis

Comparison 1 Ketoprofen 12.5 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief over 6 hours.

1.2
1.2. Analysis

Comparison 1 Ketoprofen 12.5 mg versus placebo, Outcome 2 Participants using rescue medication over 6 hours.

1.3
1.3. Analysis

Comparison 1 Ketoprofen 12.5 mg versus placebo, Outcome 3 Participants with any adverse event.

2.1
2.1. Analysis

Comparison 2 Ketoprofen 25 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief over 6 hours.

2.2
2.2. Analysis

Comparison 2 Ketoprofen 25 mg versus placebo, Outcome 2 Participants using rescue medication over 6 hours.

2.3
2.3. Analysis

Comparison 2 Ketoprofen 25 mg versus placebo, Outcome 3 Participants with any adverse event.

3.1
3.1. Analysis

Comparison 3 Ketoprofen 50 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief over 4‐6 hours.

3.2
3.2. Analysis

Comparison 3 Ketoprofen 50 mg versus placebo, Outcome 2 Participants using rescue medication over 6‐8 hours.

3.3
3.3. Analysis

Comparison 3 Ketoprofen 50 mg versus placebo, Outcome 3 Participants with any adverse event.

4.1
4.1. Analysis

Comparison 4 Ketoprofen 80 mg or 100 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief.

4.2
4.2. Analysis

Comparison 4 Ketoprofen 80 mg or 100 mg versus placebo, Outcome 2 Participants using rescue medication over 6‐8 hours.

4.3
4.3. Analysis

Comparison 4 Ketoprofen 80 mg or 100 mg versus placebo, Outcome 3 Participants with any adverse event.

5.1
5.1. Analysis

Comparison 5 Dexketoprofen 10 mg or 12.5 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief over 4‐6 hours.

5.2
5.2. Analysis

Comparison 5 Dexketoprofen 10 mg or 12.5 mg versus placebo, Outcome 2 Participants using rescue medication over 6‐8 hours.

5.3
5.3. Analysis

Comparison 5 Dexketoprofen 10 mg or 12.5 mg versus placebo, Outcome 3 Participants with any adverse event.

6.1
6.1. Analysis

Comparison 6 Dexketoprofen 20 mg or 25 mg versus placebo, Outcome 1 Participants with ≥ 50% pain relief over 4‐6 hours.

6.2
6.2. Analysis

Comparison 6 Dexketoprofen 20 mg or 25 mg versus placebo, Outcome 2 Participants using rescue medication over 6‐8 hours.

6.3
6.3. Analysis

Comparison 6 Dexketoprofen 20 mg or 25 mg versus placebo, Outcome 3 Participants with any adverse event.

Update of

Similar articles

Cited by

References

References to studies included in this review

Akural 2009 {published data only}
    1. Akural E. A combination of ketoprofen and paracetamol analgesia after oral surgery: a prospective, randomized, double‐blinded, placebo‐controlled single‐dose study. Pain Practice 2009;9 (Suppl 1):139‐40. [DOI: 10.1111/j.1533-2500.2009.00267.x] - DOI
    1. Akural EI, Järvimäki V, Länsineva A, Niinimaa A, Alahuhta S. Effects of combination treatment with ketoprofen 100 mg + acetaminophen 1000 mg on postoperative dental pain: a single‐dose, 10‐hour, randomized, double‐blind, active‐ and placebo‐controlled clinical trial. Clinical Therapeutics 2009;31(3):560‐8. [DOI: 10.1016/j.clinthera.2009.03.017] - DOI - PubMed
Arnold 1990 {published data only}
    1. Arnold JD. Ketoprofen, ibuprofen, and placebo in the relief of postoperative pain. Advances in Therapy 1990;7:264‐75.
Balzanelli 1996 {published data only}
    1. Balzanelli B, Lorenzi C. Efficacy and tolerability 80 mg granulated ketoprofen lysine salt in posttraumatic orodental pain: double blind vs placebo study. Minerva Stomatologica 1996;45(1‐2):53‐9. - PubMed
Cooper 1984 {published data only}
    1. Cooper SA, Gelb SB, Cavaliere MB, Crohn P, Dyer C. An analgesic relative potency assay comparing ketoprofen and aspirin in postoperative dental pain. Advances in Therapy 1984;1(6):410‐8.
Cooper 1988 {published data only}
    1. Cooper SA, Berrie R, Cohn P. Comparison of ketoprofen, ibuprofen, and placebo in a dental surgery pain model. Advances in Therapy 1988;5(3):43‐53.
Cooper 1998 {published data only}
    1. Cooper SA, Reynolds DC, Reynolds B, Hersh EV. Analgesic efficacy and safety of (R)‐ketoprofen in postoperative dental pain. Journal of Clinical Pharmacology 1998;38(2 Suppl):11S‐18S. [DOI: 10.1002/j.1552-4604.1998.tb04412.x] - DOI - PubMed
Gay 1996 {published data only}
    1. Gay C, Planas E, Donado M, Martinez J, Artigas R, Torres F, et al. Analgesic efficacy of low doses of dexketoprofen in the dental pain model. Clinical Drug Investigation 1996;11:320‐30. [DOI: 10.2165/00044011-199611060-00002] - DOI
Harrison 1996 {unpublished data only}
    1. Harrison F. Double‐blind randomised, parallel‐group comparison of the safety and efficacy of single oral doses of LM‐1158.tris (dexketoprofen tromethamine salt, 12.5 mg or 25 mg) to placebo in patients with moderate to severe dental pain due to removal of impacted third molar teeth. Clinical trial report 1996.
Jackson 2004 {published data only}
    1. Jackson ID, Heidemann BH, Wilson J, Power I, Brown RD. Double‐blind, randomised, placebo‐controlled trial comparing rofecoxib with dexketoprofen trometamol in surgical dentistry. British Journal of Anaesthesia 2004;92:675‐80. - PubMed
McGurk 1998 {published data only}
    1. McGurk M, Robinson P, Rajayogeswaran V, Luca M, Casini A, Artigas R, et al. Clinical comparison of dexketoprofen trometamol, ketoprofen, and placebo in postoperative dental pain. Journal of Clinical Pharmacology 1998;38(12 Suppl):46S‐54S. - PubMed
McQuay 2016 {published data only}
    1. McQuay HJ, Moore RA, Berta A, Gainutdinovs O, Fulesdi B, Porvaneckas N, et al. Randomized clinical trial of dexketoprofen/tramadol 25 mg/75 mg in moderate‐to‐severe pain after total hip arthroplasty. Revista de la Sociedad Espanola del Dolor 2015;22(5):186‐99.
    1. McQuay HJ, Moore RA, Berta A, Gainutdinovs O, Fülesdi B, Porvaneckas N, et al. Randomized clinical trial of dexketoprofen/tramadol 25 mg/75 mg in moderate‐to‐severe pain after total hip arthroplasty. British Journal of Anaesthesia 2016;116(2):269‐76. [CTG: NCT01902134; DOI: 10.1093/bja/aev457] - DOI - PMC - PubMed
Mehlisch 1984 {published data only}
    1. Mehlisch D, Frakes L, Cavaliere MB, Gelman M. Double‐blind parallel comparison of single oral doses of ketoprofen, codeine, and placebo in patients with moderate to severe dental pain. Journal of Clinical Pharmacology 1984;24(11‐12):486‐92. - PubMed
Moore 2015c {published data only}
    1. Moore RA, Gay‐Escoda C, Figueiredo R, Tóth‐Bagi Z, Dietrich T, Milleri S, et al. Dexketoprofen/tramadol: randomised double‐blind trial and confirmation of empirical theory of combination analgesics in acute pain. Journal of Headache and Pain 2015;16:541. [CTG: NCT01307020; DOI: 10.1186/s10194-015-0541-5] - DOI - PMC - PubMed
Moore 2016 {published data only}
    1. Moore RA, McQuay HJ, Tomaszewski J, Raba G, Tutunaru D, Lietuviete N, et al. Dexketoprofen/tramadol 25 mg/75 mg: randomised double‐blind trial in moderate‐to‐severe acute pain after abdominal hysterectomy. BMC Anesthesiology 2016;16:9. [CTG: NCT01904149; DOI: 10.1186/s12871-016-0174-5] - DOI - PMC - PubMed
Olson 1999 {published data only}
    1. Olson NZ, Sunshine A, Zighelboim I, Lange R. Analgesic efficacy of liquid ketoprofen compared to liquid dipyrone and placebo administered orally as drops in postepisiotomy pain. International Journal of Clinical Pharmacology and Therapeutics 1999;37(4):168‐74. - PubMed
Olson 2001 {published data only}
    1. Olson NZ, Otero AM, Marrero I, Tirado S, Cooper S, Doyle G, et al. Onset of analgesia for liquigel ibuprofen 400 mg, acetaminophen 1000 mg, ketoprofen 25 mg, and placebo in the treatment of postoperative dental pain. Journal of Clinical Pharmacology 2001;41(11):1238‐47. [DOI: 10.1177/00912700122012797] - DOI - PubMed
Schreiber 1996 {unpublished data only}
    1. Schreiber M. Double‐blind, randomized, parallel‐group comparison of the safety and efficacy of oral doses of dexketoprofen tromethaine salt (LM‐1158.TRIS, 12.5 mg or 25 mg) with racemic ketoprofen (50 mg) and placebo in patients with moderate or severe pain following orthopaedic surgery. Clinical trial report 1996.
Seymour 1996 {published data only}
    1. Seymour RA, Kelly PJ, Hawkesford JE. The efficacy of ketoprofen and paracetamol (acetaminophen) in postoperative pain after third molar surgery. British Journal of Clinical Pharmacology 1996;41(6):581‐5. [DOI: 10.1046/j.1365-2125.1996.34015.x] - DOI - PMC - PubMed
Seymour 2000 {published data only}
    1. Seymour RA, Watkinson H, Hawkesford JE, Moore U. The efficacy of buffered ketoprofen in postoperative pain after third molar surgery. European Journal of Clinical Pharmacology 2000;55(11‐12):801‐6. [DOI: 10.1007/s002280050700] - DOI - PubMed
Sunshine 1988 {published data only}
    1. Sunshine A, Olson NZ. Analgesic efficacy of ketoprofen in postpartum, general surgery, and chronic cancer pain. Journal of Clinical Pharmacology 1988;28(S1):S47‐54. [DOI: 10.1002/j.1552-4604.1988.tb05977.x] - DOI - PubMed
Sunshine 1993 {published data only}
    1. Sunshine A, Olson NZ, Zighelboim I, Castro A. Ketoprofen, acetaminophen plus oxycodone, and acetaminophen in the relief of postoperative pain. Clinical Pharmacology and Therapeutics 1993;54(5):546‐55. [DOI: 10.1038/clpt.1993.187] - DOI - PubMed
Sunshine 1998 {published data only}
    1. Sunshine A, Olson NZ, Marrero I, Tirado S. Onset and duration of analgesia for low‐dose ketoprofen in the treatment of postoperative dental pain. Journal of Clinical Pharmacology 1998;38(12):1155‐64. [DOI: 10.1177/009127009803801211] - DOI - PubMed
Turek 1988 {published data only}
    1. Turek MD, Baird WM. Double‐blind parallel comparison of ketoprofen (Orudis), acetaminophen plus codeine, and placebo in postoperative pain. Journal of Clinical Pharmacology 1988;28(12 Suppl):S23‐8. [DOI: 10.1002/j.1552-4604.1988.tb05973.x] - DOI - PubMed
Vidal 1999 {unpublished data only}
    1. Vidal F, Marinez, P, Montero, A, Puig M, Aliag L, Planell J, et al. Clinical trial to assess the analgesic efficacy and safety of LM‐1158.TRIS (12.5 and 25 mg tid) versus ketoprofen (50 mg tid) and placebo after oral administration in patients with acute post‐surgery pain. Clinical trial report 1999.

References to studies excluded from this review

Avila 1991 {published data only}
    1. Avila G, Balbo G, Biasia R, Brighenti FM, Conte R, Donini I, et al. Ketoprofen in the prevention of postoperative pain in abdominal surgery. A multicenter study. Il Giornale di chirurgia 1991;12(8‐9):456‐8. - PubMed
Bagan 1998 {published data only}
    1. Bagán JV, Lopez Arranz S, Valencia E, SantamarÍa J, Eguidazu I, Horas M, et al. Clinical comparison of dexketoprofen trometamol and dipyrone in postoperative dental pain. Journal of Clinical Pharmacology 1998;38 (Suppl):55S‐64S. - PubMed
Berti 2000 {published data only}
    1. Berti M, Albertin A, Casati A, Palmisano S, Municino G, Gama Malcher M, et al. A prospective, randomized comparison of dexketoprofen, ketoprofen or paracetamol for postoperative analgesia after outpatient knee arthroscopy. Minerva Anestesiologica 2000;66(7‐8):549‐54. - PubMed
Esparza‐Villalpando 2016 {published data only}
    1. Esparza‐Villalpando V, Chavarria‐Bolanos D, Gordillo‐Moscoso A, Masuoka‐Ito D, Martinez‐Rider R, Isiordia‐Espinoza M, et al. Comparison of the analgesic efficacy of preoperative/postoperative oral dexketoprofen trometamol in third molar surgery: a randomized clinical trial. Journal of Cranio‐Maxillofacial Surgery 2016;44(9):1350‐5. [DOI: 10.1016/j.jcms.2016.06.002] - DOI - PubMed
Gallardo 1982 {published data only}
    1. Gallardo F, Rossi E, Ciscutti V. Analgesic efficacy of ketoprofen on postoperative pain following periodontal surgery. IRCS Medical Science 1982;10(12):1036‐7.
Giudice 1987 {published data only}
    1. Giudice G, Rizzi F. Ketoprofen, tromethamine tiaprofenate, versus lysine acetyl salicylate in the control of postoperative pain. Minerva Anestesiologica 1987;53(10):587‐94. - PubMed
Jimenez‐Martinez 2004 {published data only}
    1. Jimenez‐Martinez E, Gasco‐Garcia C, Arrieta‐Blanco JJ, Gomez del Torno J, Bartolome Villar B. Study of the analgesic efficacy of dexketoprofen trometamol 25mg. vs. ibuprofen 600mg. after their administration in patients subjected to oral surgery. Medicina Oral : Organo Oficial de la Sociedad Espanola de Medicina Oral y de la Academia Iberoamericana de Patologia y Medicina Bucal 2004;9(2):143‐48(English), 138‐43(Spanish). - PubMed
Kantor 1984 {published data only}
    1. Kantor T, Cavaliere MB, Hopper M, Roepke S. A double‐blind parallel comparison of ketoprofen, codeine, and placebo in patients with moderate to severe postpartum pain. Journal of Clinical Pharmacology 1984;24(5‐5):228‐34. - PubMed
Letarget 1998 {unpublished data only}
    1. Letarget J (Principal Investigator). A comparative study on safety and efficacy of dexketoprofen trometamol versus paracetamol codeine (Dafalgan Codeine) in the treatment of moderate to severe pain in the post‐operative follow‐up of hip‐replacement surgery. Clinical trial report 1998.
Lobo 1983 {published data only}
    1. Lobo R, Gallardo F, Henriquez E, Iriarte E. Analgesic activity of ketoprofen in post‐operative oral surgery pain. IRCS Medical Science 1983;11:639‐40.
Olmedo 2001 {published data only}
    1. Olmedo MV, Galvez R, Vallecillo M. Double‐blind parallel comparison of multiple doses of ketorolac, ketoprofen and placebo administered orally to patients with postoperative dental pain. Pain 2001;90(1‐2):135‐41. - PubMed
Perez 2002 {unpublished data only}
    1. Perez A. A multicentre clinical trial evaluating the analgesic efficacy and safety of dexketoprofen trometamol (25 mg tid) versus diclofenac (50 mg tid) for the treatment of pain subsequent to ambulatory surgery. Clinical trial report 2002.
Schreiber 1998 {unpublished data only}
    1. Schreiber M. Comparison of efficacy and tolerability of oral administration of 25 mg dexketoprofen (trometamol) vs 50 mg tramadol in patients with post‐operative pain. Clinical trial report 1998.
Sunshine 1986 {published data only}
    1. Sunshine A, Zighelboim I, Laska E, Siegel C, Olson NZ, Castro A. A double‐blind, parallel comparison of ketoprofen, aspirin, and placebo in patients with postpartum pain. Journal of Clinical Pharmacology 1986;26(8):706‐11. - PubMed
Tufano 1981 {published data only}
    1. Tufano R, Santangelo E, Esposito O, Brancadoro V. Ketoprofen and postoperative pain [Ketoprofene e dolore post‐operatorio]. Acta Anaesthesiologica Italica 1981;32(2):333‐41.
Zapata 2000 {unpublished data only}
    1. Zapata A, Cegarra F, Artigas R, Keller F. Dexketoprofen vs tramadol: randomised double‐blind trial in patients with postoperative pain. Clinical trial report 2000.

References to studies awaiting assessment

Yatomi 1979 {published data only}
    1. Yatomi H, Hamada G, Ozaki T, Ogawa T. Analgesic effects of ketoprofen (Orudis) on pains following tooth extraction. Shikai Tenbo 1979;54(2):355‐8. - PubMed

Additional references

Aldington 2011
    1. Aldington DJ, McQuay HJ, Moore RA. End‐to‐end military pain management. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 2011;366(1562):268‐75. [DOI: 10.1098/rstb.2010.0214] - DOI - PMC - PubMed
Barbanoj 2001
    1. Barbanoj MJ, Antonijoan RM, Gich I. Clinical pharmacokinetics of dexketoprofen. Clinical Pharmacokinetics 2001;40(4):245‐62. [DOI: 10.2165/00003088-200140040-00002] - DOI - PubMed
Barden 2004
    1. Barden J, Edwards JE, McQuay HJ, Moore RA. Pain and analgesic response after third molar extraction and other postsurgical pain. Pain 2004;107(1‐2):86‐90. [DOI: 10.1016/j.pain.2003.09.021] - DOI - PubMed
BNF 2016
    1. British National Formulary. Peri‐operative analgesia. Non‐opioid analgesics, 2016. www.medicinescomplete.com/mc/bnf/current/PHP78461‐peri‐operative‐analges... (accessed 8 November 2016).
Bulley 2009
    1. Bulley SJ, Derry S, Moore RA, McQuay RA. Single dose oral rofecoxib for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD004604.pub2] - DOI - PMC - PubMed
Clarke 2014
    1. Clarke R, Derry S, Moore RA. Single dose oral etoricoxib for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2014, Issue 5. [DOI: 10.1002/14651858.CD004309.pub4] - DOI - PMC - PubMed
Collins 1997
    1. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres?. Pain 1997;72:95‐7. [DOI: 10.1016/S0304-3959(97)00005-5] - DOI - PubMed
Collins 2001
    1. Collins SL, Edwards J, Moore RA, Smith LA, McQuay HJ. Seeking a simple measure of analgesia for mega‐trials: is a single global assessment good enough?. Pain 2001;91(1‐2):189‐94. [DOI: 10.1016/S0304-3959(00)00435-8] - DOI - PubMed
Cook 1995
    1. Cook RJ, Sackett DL. The number needed to treat: a clinically useful measure of treatment effect. BMJ 1995;310:452‐4. [DOI: 10.1136/bmj.310.6977.452] - DOI - PMC - PubMed
Cooper 1991
    1. Cooper SA. Single‐dose analgesic studies: the upside and downside of assay sensitivity. In: Max MB, Portenoy RK, Laska EM editor(s). The Design of Analgesic Clinical Trials. Advances in Pain Research Therapy. Vol. 18, New York (NY): Raven Press, 1991:117‐24.
Dechartes 2013
    1. Dechartres A, Trinquart L, Boutron I, Ravaud P. Influence of trial sample size on treatment effect estimates: meta‐epidemiological study. BMJ 2013;346:f2304. [DOI: 10.1136/bmj.f2304] - DOI - PMC - PubMed
Dechartres 2014
    1. Dechartres A, Altman DG, Trinquart L, Boutron I, Ravaud P. Association between analytic strategy and estimates of treatment outcomes in meta‐analyses. JAMA 2014;312:623‐30. [DOI: 10.1001/jama.2014.8166] - DOI - PubMed
Derry 2009a
    1. Derry C, Derry S, Moore RA, McQuay HJ. Single dose oral ibuprofen for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD001548] - DOI - PMC - PubMed
Derry 2009b
    1. Derry P, Derry S, Moore RA, McQuay HJ. Single dose oral diclofenac for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD004768.pub2] - DOI - PMC - PubMed
Derry 2015
    1. Derry S, Wiffen PJ, Moore RA. Single dose oral diclofenac for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 7. [DOI: 10.1002/14651858.CD004768.pub3] - DOI - PMC - PubMed
Derry 2016
    1. Derry S, Cooper TE, Phillips T. Single fixed‐dose oral dexketoprofen plus tramadol for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 9. [DOI: 10.1002/14651858.CD012232.pub2] - DOI - PMC - PubMed
EPOC 2015
    1. Effective Practice, Organisation of Care (EPOC). 23. Worksheets for preparing a Summary of Findings using GRADE. Resources for review authors, 2015. Oslo: Norwegian Knowledge Centre for the Health Services. Available at: epoc.cochrane.org/epoc‐specific‐resources‐review‐authors (accessed 13 February 2017).
FitzGerald 2001
    1. FitzGerald GA, Patrono C. The coxibs, selective inhibitors of cyclooxygenase‐2. New England Journal of Medicine 2001;345(6):433‐42. [DOI: 10.1056/NEJM200108093450607] - DOI - PubMed
Grahame‐Smith 2002
    1. Grahame‐Smith DG, Aronson JK. Oxford Textbook of Clinical Pharmacology and Drug Therapy. 3rd Edition. Oxford (UK): Oxford University Press, 2002.
Gregory 2016
    1. Gregory J, McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. Journal of Clinical Nursing 2016;25(5‐6):583‐98. [DOI: 10.1111/jocn.13094] - DOI - PubMed
Guyatt 2011
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 7. Rating the quality of evidence ‐ inconsistency. Journal of Clinical Epidemiology 2011;64(12):1294‐302. [DOI: 10.1016/j.jclinepi.2011.03.017] - DOI - PubMed
Guyatt 2013a
    1. Guyatt G, Oxman AD, Sultan S, Brozek J, Glasziou P, Alonso‐Coello P, et al. GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes. Journal of Clinical Epidemiology 2013;66:151‐7. [DOI: 10.1016/j.jclinepi.2012.01.006] - DOI - PubMed
Guyatt 2013b
    1. Guyatt GH, Oxman AD, Santesso N, Helfand M, Vist G, Kunz R, et al. GRADE guidelines: 12. Preparing summary of findings tables ‐ binary outcomes. Journal of Clinical Epidemiology 2013;66:158‐72. [DOI: 10.1016/j.jclinepi.2012.01.012] - DOI - PubMed
Hawkey 1999
    1. Hawkey CJ. Cox‐2 inhibitors. Lancet 1999;353(9149):307‐14. [DOI: 10.1016/S0140-6736(98)12154-2] - DOI - PubMed
Hernández‐Diaz 2000
    1. Hernández‐Díaz S, García Rodríguez LA. Association between nonsteroidal anti‐inflammatory drugs and upper gastrointestinal tract bleeding/perforation: an overview of epidemiologic studies published in the 1990s. Archives of Internal Medicine 2000;160:2093‐9. [DOI: 10.1001/archinte.160.14.2093] - DOI - PubMed
Herrero 2003
    1. Herrero JF, Romero‐Sandoval EA, Gaitan G, Mazario J. Antinociception and the new COX inhibitors: research approaches and clinical perspectives. CNS Drug Reviews 2003;9:227‐52. [DOI: 10.1111/j.1527-3458.2003.tb00251.x] - DOI - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Jadad 1996a
    1. Jadad AR, Carroll D, Moore RA, McQuay H. Developing a database of published reports of randomised clinical trials in pain research. Pain 1996;66(2‐3):239‐46. [DOI: 10.1016/0304-3959(96)03033-3] - DOI - PubMed
Jadad 1996b
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17:1‐12. [DOI: 10.1016/0197-2456(95)00134-4] - DOI - PubMed
L'Abbé 1987
    1. L'Abbé KA, Detsky AS, O'Rourke K. Meta‐analysis in clinical research. Annals of Internal Medicine 1987;107:224‐33. [DOI: 10.7326/0003-4819-107-2-224] - DOI - PubMed
Laporte 2004
    1. Laporte JR, Ibanez L, Vidal X, Vendrell L, Leone R. Upper gastrointestinal bleeding associated with the use of NSAIDs: newer versus older agents. Drug Safety 2004;27(6):411‐20. [DOI: 10.2165/00002018-200427060-00005] - DOI - PubMed
McQuay 1982
    1. McQuay HJ, Bullingham RE, Moore RA, Evans PJ, Lloyd JW. Some patients don't need analgesics after surgery. Journal of the Royal Society of Medicine 1982;75(9):705‐8. - PMC - PubMed
McQuay 2005
    1. McQuay HJ, Moore RA. Placebo. Postgraduate Medical Journal 2005;81:155‐60. [DOI: 10.1136/pgmj.2004.024737] - DOI - PMC - PubMed
McQuay 2007
    1. McQuay HJ, Moore RA. Dose‐response in direct comparisons of different doses of aspirin, ibuprofen and paracetamol (acetaminophen) in analgesic studies. British Journal of Clinical Pharmacology 2007;63(3):271‐8. [DOI: 10.1111/j.1365-2125.2006.02723.x] - DOI - PMC - PubMed
McQuay 2012
    1. McQuay HJ, Derry S, Eccleston C, Wiffen PJ, Moore RA. Evidence for analgesic effect in acute pain ‐ 50 years on. Pain 2012;153(7):1364‐7. [DOI: 10.1016/j.pain.2012.01.024] - DOI - PubMed
Moore 1996
    1. Moore A, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics. Pain 1996;66(2‐3):229‐37. [DOI: 10.1016/0304-3959(96)03032-1] - DOI - PubMed
Moore 1997a
    1. Moore A, Moore O, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics: use of pain intensity and visual analogue scales. Pain 1997;69(3):311‐5. [DOI: 10.1016/S0304-3959(96)03251-4] - DOI - PubMed
Moore 1997b
    1. Moore A, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics: verification from independent data. Pain 1997;69(1‐2):127‐30. [DOI: 10.1016/S0304-3959(96)03306-4] - DOI - PubMed
Moore 1998
    1. Moore RA, Gavaghan D, Tramèr MR, Collins SL, McQuay HJ. Size is everything‐large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain 1998;78(3):209‐16. [DOI: 10.1016/S0304-3959(98)00140-7] - DOI - PubMed
Moore 2003
    1. Moore RA, Edwards J, Barden J, McQuay HJ. Measuring pain. Bandolier's Little Book of Pain. Oxford (UK): Oxford University Press, 2003:7‐13. [ISBN: 0‐19‐263247‐7]
Moore 2005
    1. Moore RA, Edwards JE, McQuay HJ. Acute pain: individual patient meta‐analysis shows the impact of different ways of analysing and presenting results. Pain 2005;116(3):322‐31. [DOI: 10.1016/j.pain.2005.05.001] - DOI - PubMed
Moore 2006
    1. Moore A, McQuay H. Bandolier's Little Book of Making Sense of the Medical Evidence. Oxford (UK): Oxford University Press, 2006. [ISBN: 0‐19‐856604‐2]
Moore 2008a
    1. Moore RA, Barden J, Derry S, McQuay HJ. Managing potential publication bias. In: McQuay HJ, Kalso E, Moore RA editor(s). Systematic Reviews in Pain Research: Methodology Refined. Seattle: IASP Press, 2008:15‐24. [ISBN: 978‐0‐931092‐69‐5]
Moore 2008b
    1. Moore RA, Barden J, Derry S, McQuay HJ. Managing potential publication bias. In: McQuay HJ, Kalso E, Moore RA editor(s). Systematic Reviews in Pain Research: Methodology Refined. Seattle (WA): IASP Press, 2008:15‐24. [ISBN: 978‐0‐931092‐69‐5]
Moore 2008c
    1. Moore RA, Barden J. Systematic review of dexketoprofen in acute and chronic pain. BMC Clinical Pharmacology 2008;8:11. [DOI: 10.1186/1472-6904-8-11] - DOI - PMC - PubMed
Moore 2013
    1. Moore RA, Straube S, Aldington D. Pain measures and cut‐offs ‐ 'no worse than mild pain' as a simple, universal outcome. Anaesthesia 2013;68(4):400‐12. [DOI: 10.1111/anae.12148] - DOI - PubMed
Moore 2014
    1. Moore RA, Derry S, Straube S, Ireson‐Paine J, Wiffen PJ. Faster, higher, stronger? Evidence for formulation and efficacy for ibuprofen in acute pain. Pain 2014;155(1):14‐21. [DOI: 10.1016/j.pain.2013.08.013] - DOI - PubMed
Moore 2015a
    1. Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults ‐ an overview of Cochrane reviews. Cochrane Database of Systematic Reviews 2015, Issue 9. [DOI: 10.1002/14651858.CD008659.pub3] - DOI - PMC - PubMed
Moore 2015b
    1. Moore RA, Derry S, Aldington D, Wiffen PJ. Adverse events associated with single dose oral analgesics for acute postoperative pain in adults ‐ an overview of Cochrane reviews. Cochrane Database of Systematic Reviews 2015, Issue 10. [DOI: 10.1002/14651858.CD011407.pub2] - DOI - PMC - PubMed
Nüesch 2010
    1. Nüesch E, Trelle S, Reichenbach S, Rutjes AW, Tschannen B, Altman DG, et al. Small study effects in meta‐analyses of osteoarthritis trials: meta‐epidemiological study. BMJ 2010;341:c3515. [DOI: 10.1136/bmj.c3515] - DOI - PMC - PubMed
PACT 2016
    1. Prescribing and Medicines Team Health and Social Care Information Centre. Prescription Cost Analysis, England 2015. Leeds (UK): Health and Social Care Information Centre, 2016. [ISBN: 978‐1‐78386‐680‐9]
PaPaS 2012
    1. Cochrane Pain, Palliative and Supportive Care Group (PaPaS) author and referee guidance. papas.cochrane.org/papas‐documents (accessed 23 February 2017).
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Thorlund 2011
    1. Thorlund K, Imberger G, Walsh M, Chu R, Gluud C, Wetterslev J, et al. The number of patients and events required to limit the risk of overestimation of intervention effects in meta‐analysis ‐ a simulation study. PloS One 2011;6(10):e25491. [DOI: 10.1371/journal.pone.0025491] - DOI - PMC - PubMed
Toms 2008
    1. Toms L, McQuay HJ, Derry S, Moore RA. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD004602.pub2] - DOI - PMC - PubMed
Tramèr 1997
    1. Tramèr MR, Reynolds DJ, Moore RA, McQuay HJ. Impact of covert duplicate publication on meta‐analysis: a case study. BMJ 1997;315(7109):635‐40. [DOI: 10.1136/bmj.315.7109.635] - DOI - PMC - PubMed
Visentin 2005
    1. Visentin M, Zanolin E, Trentin L, Sartori S, Marco R. Prevalence and treatment of pain in adults admitted to Italian hospitals. European Journal of Pain 2005;9(1):61‐7. [DOI: 10.1016/j.ejpain.2004.04.004] - DOI - PubMed

References to other published versions of this review

Barden 2009
    1. Barden J, Derry S, McQuay HJ, Moore RA. Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD007355.pub2] - DOI - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources