[Show abstract][Hide abstract] ABSTRACT: Pain is commonly experienced after surgical procedures and multiple medications are routinely used to control it. This review assessed data from 36 studies of participants (3896 in total) experiencing moderate to severe pain after various operations. It found that intravenous (IV) formulations of paracetamol (either IV propacetamol or IV paracetamol) provided pain relief for a period of four hours for about 40% of participants. Direct comparisons with other pain killers, such as morphine and anti-inflammatories, did not show any difference in effectiveness, although this may have been due to the small numbers of participants in these comparisons (i.e. the studies were not statistically powered to show a difference). IV propacetamol and IV paracetamol produced few side effects. However, participants receiving IV propacetamol complained of pain at the site their medication was infused at more often than those receiving placebo or IV paracetamol.
Full-text · Article · Oct 2011 · Cochrane database of systematic reviews (Online)
[Show abstract][Hide abstract] ABSTRACT: Paracetamol is the most commonly prescribed analgesic for the treatment of acute pain. The efficacy and safety of i.v. formulations of paracetamol is unclear. We performed a systematic search (multiple databases, bibliographies, any language, to May 2010) for single-dose, randomized, controlled clinical trials of propacetamol or i.v. paracetamol for acute postoperative pain in adults or children. Thirty-six studies involving 3896 patients were included. For the primary outcome, 37% of patients (240/367) receiving propacetamol or i.v. paracetamol experienced at least 50% pain relief over 4 h compared with 16% (68/527) receiving placebo (number needed to treat=4.0; 95% confidence interval, 3.5-4.8). The proportion of patients in propacetamol or i.v. paracetamol groups experiencing at least 50% pain relief diminished over 6 h. Patients receiving propacetamol or paracetamol required 30% less opioid over 4 h and 16% less opioid over 6 h than those receiving placebo. However, this did not translate to a reduction in opioid-induced adverse events (AEs). Similar comparisons between propacetamol or i.v. paracetamol and active comparators were either not statistically significant, not clinically significant, or both. AEs occurred at similar rates with propacetamol or i.v. paracetamol and placebo. However, pain on infusion occurred more frequently in those receiving propacetamol compared with placebo (23% vs 1%). A single dose of either propacetamol or i.v. paracetamol provides around 4 h of effective analgesia for about 37% of patients with acute postoperative pain. Both formulations are associated with few AEs, although patients receiving propacetamol have a higher incidence of pain on infusion.
Full-text · Article · Jun 2011 · BJA British Journal of Anaesthesia