Cochrane · systematic review · CD015087
Diclofenac for acute postoperative pain in children
Ringsten, M, Kredo, T, Ebrahim, S, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
32
current version
GRADE rated
13
No studies
6
Included studies
NR
No studies 6 · 18.8%Ungraded 13 · 40.6%Very low 11 · 34.4%Low 0 · 0%Moderate 2 · 6.3%High 0 · 0%
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
Diclofenac versus placebo for treating postoperative pain in children
Population: children with acute postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome№ of participants(studies) Diclofenac vs placebo | no estimate extracted | NR | No studies |
Pain relief 50% ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs placebo | no estimate extracted | 50 participants | Ungraded |
Pain relief 50% ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs placebo | no estimate extracted | 50 participants | Ungraded |
Pain intensity ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs placebo | no estimate extracted | 0 participants | Ungraded |
Pain intensity ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs placebo | no estimate extracted | 2 participants | Ungraded |
Nausea, vomiting, or both during study period № of participants: 100(2 RCTs) Diclofenac vs placebo | RR 0.83 [0.38, 1.8] | 2 studies · 100 participants | Very low Downgraded: risk of bias, imprecision |
Any bleeding during study period № of participants: 100(2 RCTs)d Diclofenac vs placebo | RR 3 [0.34, 26.45] | 2 studies · 100 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events during study period (not reported) Diclofenac vs placebo | no estimate extracted | NR | No studies |
Diclofenac versus opioids for treating postoperative pain in children
Population: children with acute postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome№ of participants(studies) Diclofenac vs opioids | no estimate extracted | NR | No studies |
Pain relief 50% ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs opioids | no estimate extracted | 50 participants | Ungraded |
Pain relief 50% ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs opioids | no estimate extracted | 50 participants | Ungraded |
Pain intensity ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs opioids | no estimate extracted | 0 participants | Ungraded |
Pain intensity ‐ as reported by child, at 2 to 24 hours № of participants: 50 (1 RCT) Diclofenac vs opioids | no estimate extracted | 1 study · 2 participants | Very low Downgraded: risk of bias, imprecision |
Nausea, vomiting, or both during study period № of participants: 463 (7 RCTs) Diclofenac vs opioids | RR 0.75 [0.58, 0.96] | 7 studies · 463 participants | Moderate Downgraded: risk of bias |
Any bleeding during study period № of participants: 222 (2 RCTs) Diclofenac vs opioids | RR 3.06 [1.31, 7.13] | 2 studies · 222 participants | Moderate Downgraded: imprecision |
Serious adverse events during study period (not reported) Diclofenac vs opioids | no estimate extracted | NR | No studies |
Diclofenac versus paracetamol for treating postoperative pain in children
Population: children with acute postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome№ of participants(studies) Diclofenac vs paracetamol | no estimate extracted | NR | No studies |
Pain relief 50% ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs paracetamol | no estimate extracted | 50 participants | Ungraded |
Pain relief 50% ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs paracetamol | no estimate extracted | 50 participants | Ungraded |
Pain intensity ‐ as reported by child, at 0 to 2 hours № of participants: 180 (2 RCTs) Diclofenac vs paracetamol | no estimate extracted | 0 studies · 2 participants | Very low Downgraded: risk of bias, imprecision |
Pain intensity ‐ as reported by child, at 2 to 24 hours № of participants: 300 (3 RCTs) Diclofenac vs paracetamol | no estimate extracted | 2 studies · 3 participants | Very low Downgraded: risk of bias, inconsistency |
Nausea, vomiting, or both during study period № of participants: 348 (5 RCTs) Diclofenac vs paracetamol | RR 0.47 [0.25, 0.87] | 5 studies · 348 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Any bleeding during study period № of participants: 332 (5 RCTs) Diclofenac vs paracetamol | RR 0.57 [0.12, 2.62] | 5 studies · 332 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events during study period № of participants: 60 (1 RCT) Diclofenac vs paracetamol | RR 0.5 [0.05, 5.22] | 1 study · 60 participants | Very low Downgraded: imprecision |
Diclofenac versus bupivacaine for treating postoperative pain in children
Population: children with acute postoperative pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome№ of participants(studies) Diclofenac vs bupivacaine | no estimate extracted | NR | No studies |
Pain relief 50% ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs bupivacaine | no estimate extracted | 50 participants | Ungraded |
Pain relief 50% ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs bupivacaine | no estimate extracted | 50 participants | Ungraded |
Pain intensity ‐ as reported by child, at 0 to 2 hours (not reported) Diclofenac vs bupivacaine | no estimate extracted | 0 participants | Ungraded |
Pain intensity ‐ as reported by child, at 2 to 24 hours (not reported) Diclofenac vs bupivacaine | no estimate extracted | 2 participants | Ungraded |
Nausea, vomiting, or both during study period № of participants: 128 (3 RCTs) Diclofenac vs bupivacaine | RR 1.28 [0.58, 2.78] | 3 studies · 128 participants | Very low Downgraded: risk of bias, imprecision |
Any bleeding during study period № of participants: 38 (1 RCTs) Diclofenac vs bupivacaine | RR 1.8 [0.18, 18.21] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events during the study period № of participants: 38 (1 RCTs) Diclofenac vs bupivacaine | RR 4.52 [0.23, 88.38] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |