Cochrane · systematic review · CD007126
Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain
McNicol, ED, Ferguson, MC, Haroutounian, S, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Pain, Palliative and Supportive CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
34
current version
GRADE rated
34
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 16 · 47.1%Low 11 · 32.4%Moderate 6 · 17.6%High 1 · 2.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Proportion of participants experiencing at least 50% of maximum pain relief at 4 hours
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Para/propacetamol vs placebo see footnote1 | RR 2.53 [2.01, 3.19] | 11 studies · 1149 participants | High |
Paracetamol vs placebo see footnote1 | RR 4.8 [2.3, 10] | 5 studies · 393 participants | Moderate Downgraded: inconsistency |
Propacetamol vs placebo see footnote1 | RR 2.19 [1.74, 2.77] | 8 studies · 756 participants | Moderate Downgraded: inconsistency |
Para/propacetamol vs NSAIDs see footnote1 | RR 1.01 [0.86, 1.18] | 5 studies · 353 participants | Low |
Paracetamol vs NSAIDs see footnote1 | RR 0.9 [0.72, 1.13] | 2 studies · 130 participants | Very low Downgraded: imprecision |
Propacetamol vs NSAIDs see footnote1 | RR 1.08 [0.86, 1.34] | 3 studies · 223 participants | Very low Downgraded: imprecision, inconsistency |
Paracetamol vs propacetamol see footnote1 | RR 0.98 [0.77, 1.24] | 3 studies · 361 participants | Moderate |
Proportion of participants experiencing at least 50% of maximum pain relief at 6 hours
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Para/propacetamol vs placebo see footnote1 | RR 2.86 [2.1, 3.91] | 10 studies · 1143 participants | Moderate Downgraded: inconsistency |
Paracetamol vs placebo see footnote1 | RR 3.65 [2.15, 6.21] | 6 studies · 532 participants | Moderate Downgraded: inconsistency |
Propacetamol vs placebo see footnote1 | RR 2.4 [1.64, 3.5] | 6 studies · 611 participants | Low Downgraded: imprecision, inconsistency, publication bias |
Para/propacetamol vs NSAIDs see footnote1 | RR 0.79 [0.66, 0.95] | 5 studies · 355 participants | Very low Downgraded: publication bias |
Paracetamol vs NSAIDs see footnote1 | RR 0.82 [0.66, 1.02] | 3 studies · 212 participants | Very low Downgraded: imprecision |
Propacetamol vs NSAIDs see footnote1 | RR 0.75 [0.56, 1.02] | 2 studies · 143 participants | Very low Downgraded: imprecision |
Paracetamol vs propacetamol see footnote1 | RR 0.94 [0.73, 1.2] | 3 studies · 361 participants | Low Downgraded: imprecision |
Mean pain intensity over a 4‐hour period
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Paracetamol vs placebo | no estimate extracted | 6 studies · 485 participants | Low Downgraded: risk of bias, imprecision |
Paracetamol vs NSAIDs | no estimate extracted | 6 studies · 350 participants | Very low Downgraded: risk of bias, inconsistency |
Mean pain intensity over a 6‐hour period
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Paracetamol vs placebo | no estimate extracted | 12 studies · 837 participants | Low Downgraded: inconsistency |
Paracetamol vs NSAIDs | no estimate extracted | 9 studies · 524 participants | Very low Downgraded: risk of bias, inconsistency |
Proportion of participants receiving additional analgesic medication
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Para/propacetamol vs placebo | RR 0.7 [0.64, 0.77] | 9 studies · 859 participants | Low Downgraded: risk of bias, inconsistency |
Paracetamol vs placebo | RR 0.75 [0.69, 0.82] | 6 studies · 655 participants | Low Downgraded: risk of bias, inconsistency |
Propacetamol vs placebo | RR 0.49 [0.35, 0.69] | 3 studies · 204 participants | Low Downgraded: risk of bias, inconsistency |
Para/propacetamol vs NSAIDs | RR 1.19 [0.87, 1.63] | 5 studies · 309 participants | Very low Downgraded: risk of bias, imprecision |
Paracetamol vs NSAIDs | RR 1.08 [0.59, 1.98] | 2 studies · 120 participants | Very low Downgraded: risk of bias, imprecision |
Propacetamol vs NSAIDs | RR 1.23 [0.86, 1.77] | 3 studies · 189 participants | Very low Downgraded: risk of bias, imprecision |
Propacetamol vs opioids | RR 1.83 [0.72, 4.64] | 2 studies · 139 participants | Very low Downgraded: risk of bias, imprecision |
Opioid consumption (IV morphine equivalents) over 6 hours
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Para/propacetamol vs placebo see footnote1 | no estimate extracted | 13 studies · 777 participants | Moderate Downgraded: risk of bias |
Paracetamol vs placebo see footnote1 | no estimate extracted | 8 studies · 404 participants | Low Downgraded: risk of bias, inconsistency |
Propacetamol vs placebo see footnote1 | no estimate extracted | 6 studies · 373 participants | Low Downgraded: risk of bias, inconsistency |
Para/propacetamol vs NSAIDs see footnote1 | no estimate extracted | 8 studies · 540 participants | Very low Downgraded: risk of bias |
Paracetamol vs NSAIDs see footnote1 | no estimate extracted | 3 studies · 160 participants | Very low Downgraded: imprecision |
Propacetamol vs NSAIDs see footnote1 | no estimate extracted | 5 studies · 380 participants | Very low Downgraded: imprecision |
Proportion of participants vomiting
Population: patients with postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Para/propacetamol vs placebo | RR 0.7 [0.57, 0.87] | 15 studies · 1414 participants | Very low Downgraded: inconsistency, publication bias |
Paracetamol vs placebo | RR 0.64 [0.51, 0.8] | 13 studies · 1037 participants | Very low Downgraded: publication bias |
Propacetamol vs placebo | RR 1.62 [0.75, 3.48] | 3 studies · 377 participants | Low Downgraded: imprecision |