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Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis.
Br J Anaesth. 2011 Jun; 106(6):764-75.BJ

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.

Authors+Show Affiliations

Department of Pharmacy and 2 Department of Anesthesiology, Tufts Medical Center, 800 Washington Street, Box 420, Boston, MA 02129,USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

21558067

Citation

McNicol, E D., et al. "Single-dose Intravenous Paracetamol or Propacetamol for Prevention or Treatment of Postoperative Pain: a Systematic Review and Meta-analysis." British Journal of Anaesthesia, vol. 106, no. 6, 2011, pp. 764-75.
McNicol ED, Tzortzopoulou A, Cepeda MS, et al. Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis. Br J Anaesth. 2011;106(6):764-75.
McNicol, E. D., Tzortzopoulou, A., Cepeda, M. S., Francia, M. B., Farhat, T., & Schumann, R. (2011). Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis. British Journal of Anaesthesia, 106(6), 764-75. https://doi.org/10.1093/bja/aer107
McNicol ED, et al. Single-dose Intravenous Paracetamol or Propacetamol for Prevention or Treatment of Postoperative Pain: a Systematic Review and Meta-analysis. Br J Anaesth. 2011;106(6):764-75. PubMed PMID: 21558067.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis. AU - McNicol,E D, AU - Tzortzopoulou,A, AU - Cepeda,M S, AU - Francia,M B D, AU - Farhat,T, AU - Schumann,R, Y1 - 2011/05/09/ PY - 2011/5/12/entrez PY - 2011/5/12/pubmed PY - 2011/7/16/medline SP - 764 EP - 75 JF - British journal of anaesthesia JO - Br J Anaesth VL - 106 IS - 6 N2 - 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. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/21558067/Single_dose_intravenous_paracetamol_or_propacetamol_for_prevention_or_treatment_of_postoperative_pain:_a_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)33173-2 DB - PRIME DP - Unbound Medicine ER -