Non-Cochrane · intervention · PM41739420
Efficacy and Harms of Opioid Analgesics for Acute Pain: Overview of Systematic Reviews and Meta-analyses.
Mathieson Stephanie, Zadro Joshua R, Narayan Sujita W, et al. · Drugs · 2026 · PubMed · doi:10.1007/s40265-026-02284-3
Findings
190 findings
| Population | ||||
|---|---|---|---|---|
| Children and adults with acute abdominal pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -18.4 [-31.9, -5] High 12 studies · 1596 participants |
| Children and adults with acute abdominal pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Timepoint not reported · acute pain condition · Source review Gavriilidis 2019 (age 12 years and older); morphine, tramadol, pethidine, papaveretum | MD -17.6 [-25, -10.3] GRADE not reported 12 studies · 1314 participants |
| Children and adults with acute abdominal pain | Opioid analgesics | Placebo or no active treatment | Adverse events (incidence of events) Long term (>48 h) · acute pain condition · Source review Poonai 2014 (children); IV morphine or oxycodone, incidence of events 11/232 vs 0/240; pooled by the overview from raw data | RD 0.05 [0.02, 0.07] GRADE not reported 6 studies · 472 participants |
| Children and adults with acute abdominal pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition · Source review Poonai 2014 (children); morphine or oxycodone, IV 0.1 or 0.15 mg/kg single dose | MD -19.6 [-40.37, 1.16] GRADE not reported 5 studies · 282 participants |
| Surgical patients with morphine-induced pruritus (acute pain) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · acute pain condition | MD -2.2 [-3.7, -0.7] Moderate Downgraded: imprecision 5 studies · 284 participants |
| Surgical patients with morphine-induced pruritus (acute pain) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · acute pain condition | MD -7.9 [-15.2, -0.6] High 9 studies · 424 participants |
| Surgical patients with morphine-induced pruritus (acute pain) | Opioid analgesics | Placebo or no active treatment | Adverse event: somnolence Intermediate term (>6 to <=48 h) · acute pain condition · Source review Du 2013; butorphanol IV, intrathecal or epidural; 4/68 vs 5/55 | RR 0.71 [0.22, 2.37] GRADE not reported 3 studies |
| Surgical patients with morphine-induced pruritus (acute pain) | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Intermediate term (>6 to <=48 h) · acute pain condition · Source review Du 2013; butorphanol IV, intrathecal or epidural; 20/175 vs 13/136 | RR 2.45 [0.35, 17.14] GRADE not reported 5 studies |
| Surgical patients with morphine-induced pruritus (acute pain) | Opioid analgesics | Placebo or no active treatment | Adverse event: respiratory depression Intermediate term (>6 to <=48 h) · acute pain condition · Source review Du 2013; butorphanol IV, intrathecal or epidural; 9/244 vs 11/210 | RR 0.71 [0.31, 1.63] GRADE not reported 10 studies |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse event: vomiting Timepoint not reported · acute pain condition · Source review Huang 2022 (caesarean); sufentanil in spinal anaesthesia, dose not reported, 59/250 vs 53/253 | RR 1.04 [0.75, 1.44] GRADE not reported 8 studies |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -4 [-13.6, 5.6] Low Downgraded: risk of bias, imprecision 2 studies · 281 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse event: hypotension Timepoint not reported · acute pain condition · Source review Huang 2022 (caesarean); sufentanil in spinal anaesthesia, dose not reported, 72/129 vs 69/126 | RR 1.03 [0.87, 1.22] GRADE not reported 4 studies |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse event: pruritus Timepoint not reported · acute pain condition · Source review Huang 2022 (caesarean); sufentanil in spinal anaesthesia, dose not reported, 90/225 vs 23/228 | RR 5.25 [1.9, 14.49] GRADE not reported 8 studies |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Short term (>3 to <=6 h) · acute pain condition · Source review Deussen 2020; oral codeine 60 mg up to 2 doses, maternal AEs, 21/78 vs 18/63 | RR 0.95 [0.54, 1.67] GRADE not reported 3 studies · 141 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · acute pain condition | MD -6.6 [-12.2, -1] Moderate Downgraded: imprecision 3 studies · 395 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Short term (>3 to <=6 h) · acute pain condition · Source review Deussen 2020; oral codeine any dose, maternal AEs, 48/109 vs 21/79 | RR 1.59 [0.99, 2.55] GRADE not reported 3 studies · 188 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea Timepoint not reported · acute pain condition · Source review Huang 2022 (caesarean); sufentanil in spinal anaesthesia, dose not reported, 15/256 vs 27/253 | RR 0.61 [0.33, 1.11] GRADE not reported 8 studies |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · acute pain condition · Source review Deussen 2020; oral codeine, less than 120 mg | RR 1.26 [0.99, 1.61] GRADE not reported 5 studies · 299 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Short term (>3 to <=6 h) · acute pain condition | RR 1.7 [0.9, 3.4] Moderate Downgraded: imprecision 7 studies · 376 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · acute pain condition | MD -2 [-3.6, -0.4] High 3 studies · 426 participants |
| Women with acute postpartum pain | Opioid analgesics | Placebo or no active treatment | Adverse event: shivering Timepoint not reported · acute pain condition · Source review Huang 2022 (caesarean); sufentanil in spinal anaesthesia, dose not reported, 23/154 vs 45/154 | RR 0.58 [0.27, 1.26] GRADE not reported 5 studies |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: drowsiness Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral codeine 60 mg + paracetamol 600 to 650 mg | RD 6.22 [0.58, 18.2] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 5 mg or codeine 60 mg | RD 7.73 [0.93, 21.83] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical · Source review Abdel Shaheed 2019; codeine 15 or 30 mg + ibuprofen 200 or 400 mg, single dose | MD -12.7 [-18.5, -6.9] GRADE not reported 3 studies · 211 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain relief (Likert 0 to 4) Short term (>3 to <=6 h) · post-surgical · Source review Miroshnychenko 2023; oral oxycodone 10 mg + paracetamol 650 mg | MD 1.15 [0.67, 1.62] GRADE not reported 5 studies |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 5 mg or codeine 60 mg | RD 8.55 [-2.87, 33.08] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral codeine 60 mg + paracetamol 600 to 650 mg | RD 3.76 [0.25, 9.95] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Immediate term (<=3 h) · post-surgical | RD 0 [-0.2, 0.2] Low Downgraded: imprecision 1 study · 20 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: headache Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral tramadol 37.5 mg + paracetamol 325 mg | RD -3.55 [-4.88, 2.84] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain relief (Likert 0 to 4) Short term (>3 to <=6 h) · post-surgical · Source review Miroshnychenko 2023; oral oxycodone 5 mg or codeine 60 mg | MD 0.1 [-0.06, 0.25] GRADE not reported 7 studies |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -10.9 [-13.2, -8.5] Low Downgraded: risk of bias, inconsistency 9 studies · 1754 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: constipation Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral codeine 60 mg + paracetamol 600 to 650 mg | RD -0.09 [-0.89, 28.94] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -19.5 [-25, -14] Moderate Downgraded: risk of bias 9 studies · 1159 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral tramadol 37.5 mg + paracetamol 325 mg | RD -2.42 [-6.07, 6.03] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 10 mg + paracetamol 650 mg | RD 15.08 [4.64, 30.15] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Long term (>48 h) · post-surgical | MD -13.9 [-21.3, -6.5] High 3 studies · 833 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: headache Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 5 mg or codeine 60 mg | RD -2.08 [-4.31, 5.16] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -15.1 [-20.5, -9.8] Moderate Downgraded: risk of bias 12 studies · 1899 participants |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 10 mg + paracetamol 650 mg | RD 6.82 [2.07, 14.73] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral tramadol 37.5 mg + paracetamol 325 mg | RD 1.1 [-1.93, 8.64] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: headache Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral codeine 60 mg + paracetamol 600 to 650 mg | RD -1.08 [-2.63, 1.35] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain relief (Likert 0 to 4) Short term (>3 to <=6 h) · post-surgical · Source review Miroshnychenko 2023; oral codeine 60 mg + paracetamol 600 to 650 mg | MD 0.48 [0.33, 0.63] GRADE not reported 12 studies |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral codeine 60 mg + paracetamol 600 to 650 mg | RD 4.99 [0.08, 12.1] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Adverse event: headache Timepoint not reported · post-surgical · Source review Miroshnychenko 2023 (age 12 years and older); oral oxycodone 10 mg + paracetamol 650 mg | RD 1.03 [-4.38, 13.45] GRADE not reported Studies not reported |
| Adults and adolescents with acute pain after dental surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical · Source review Abdel Shaheed 2019; codeine 15 or 30 mg + ibuprofen 200 or 400 mg, single dose | MD -4.3 [-11.6, 3] GRADE not reported 3 studies · 155 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Disability Long term (>48 h) · acute pain condition · Source review Jones 2024; oral opioids, any dose (N = 233 + 183) | MD -5.8 [-13.7, 2.1] GRADE not reported 2 studies · 416 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · acute pain condition | MD -8.9 [-13.5, -4.3] Moderate Downgraded: inconsistency 7 studies · 1080 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition · Single-dose IV morphine for sciatica | MD -42.5 [-49.9, -35.1] Moderate Downgraded: imprecision 1 study · 197 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · acute pain condition · Source review Jones 2024; oral opioids, any dose, 659/1858 vs 36/1063; printed as RD 14.3% (95% CI 8.3% to 20.4%) | RD 0.143 [0.083, 0.204] GRADE not reported 11 studies · 2921 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · acute pain condition · Source review Jones 2024; oral opioids in children, 48/239 vs 10/154; printed as RD 10.4% (95% CI 0.6% to 21.4%) | RD 0.104 [0.006, 0.214] GRADE not reported 3 studies · 393 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Disability Intermediate term (>6 to <=48 h) · acute pain condition · Source review Jones 2024; oral opioids, any dose (N = 129 + 79) | MD -6.2 [-17.8, 5.4] GRADE not reported 2 studies · 208 participants |
| Adults and children with acute musculoskeletal pain (includes sciatica) | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · acute pain condition | RD 0.1 [0, 0.2] High 9 studies · 2193 participants |
| Children with acute pain after myringotomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -15 [-19.6, -10.4] Moderate Downgraded: imprecision 1 study · 260 participants |
| Women with acute pain after hysterectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -12.8 [-24.4, -1.3] Moderate Downgraded: risk of bias 7 studies · 487 participants |
| Women with acute pain after hysterectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD 0.6 [-7, 8.2] Moderate Downgraded: imprecision 2 studies · 168 participants |
| Women with acute pain after hysterectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -6.3 [-11, -1.7] Low Downgraded: risk of bias, imprecision 3 studies · 289 participants |
| Women with acute pain after hysterectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Long term (>48 h) · post-surgical | MD -0.2 [-7.9, 7.5] Very low Downgraded: risk of bias, imprecision 1 study · 79 participants |
| Post surgical: Mixed | Opioid analgesics (any opioid, dose, route or regimen) | Placebo or no active treatment | Serious adverse events Short term (>3 to <=6 h) | RD -0.0 [-0.0, 0.0] Low Downgraded: risk of bias, imprecision 5 studies · 604 participants |
| Post surgical: Mixed | Opioid analgesics (any opioid, dose, route or regimen) | Placebo or no active treatment | Adverse events leading to study withdrawal Intermediate term (>6 to <=48 h) | RD 0.0 [-0.0, 0.0] Very low Downgraded: risk of bias, imprecision, publication bias 2848 participants |
| People with acute pain after H-uvulopalatopharyngoplasty for sleep apnea | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD 0 [-0.3, 0.3] Moderate Downgraded: imprecision 1 study · 260 participants |
| People with acute pain after H-uvulopalatopharyngoplasty for sleep apnea | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD 0 [-0.3, 0.3] Moderate Downgraded: imprecision 1 study · 260 participants |
| People with acute pain after H-uvulopalatopharyngoplasty for sleep apnea | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -12.7 [-22.7, -2.8] Moderate Downgraded: imprecision 1 study · 260 participants |
| Adults with acute traumatic limb pain | Opioid analgesics | Placebo or no active treatment | Serious adverse events Immediate term (<=3 h) · acute pain condition | RD 0 [0, 0] Moderate Downgraded: imprecision 1 study · 142 participants |
| Adults with acute traumatic limb pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -12 [-19, -5] Moderate Downgraded: imprecision 1 study · 144 participants |
| Adults with acute traumatic limb pain | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Immediate term (<=3 h) · acute pain condition | RR 3 [1.9, 4.8] Moderate Downgraded: imprecision 1 study · 144 participants |
| Adults with acute pain after spinal orthopaedic surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -10 [-12.5, -7.5] Low Downgraded: imprecision 1 study · 70 participants |
| Adults with acute pain after spinal orthopaedic surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -10 [-12.5, -7.5] Moderate Downgraded: imprecision 1 study · 150 participants |
| Adults with acute pain after spinal orthopaedic surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -10 [-12.5, -7.5] Low Downgraded: imprecision 1 study · 70 participants |
| People with acute pain after cardiac surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -14 [-23.8, -4.2] Very low Downgraded: risk of bias, imprecision 2 studies · 83 participants |
| People with acute pain after cardiac surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -8.8 [-15.2, -2.4] Moderate Downgraded: imprecision 7 studies · 360 participants |
| People with acute pain after cardiac surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -12.5 [-29.2, 4.2] Low Downgraded: imprecision 2 studies · 83 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: pruritus Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 29/475 vs 1/316; pooled by the overview from raw data | RR 19.29 [2.64, 140.91] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: urinary retention Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 13/475 vs 2/316; pooled by the overview from raw data | RR 4.32 [0.98, 19.03] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: dizziness Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 13/475 vs 4/316; pooled by the overview from raw data | RR 2.16 [0.71, 6.57] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: anaemia Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 16/475 vs 2/316; pooled by the overview from raw data | RR 5.32 [1.23, 22.99] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral codeine 30 or 60 mg + paracetamol (any strength), single dose | RR 1.4 [1.2, 1.6] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Derry 2015; oral codeine 25.6 to 60 mg (high dose) + ibuprofen 400 mg, single dose | RR 4.09 [2.82, 5.93] GRADE not reported 4 studies · 443 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: vomiting Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 59/475 vs 20/316; pooled by the overview from raw data | RR 1.96 [1.21, 3.19] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral tramadol 100 mg, single dose (7 trials) | RR 3.8 [2.4, 5.8] GRADE not reported 7 studies · 578 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Serious adverse events Short term (>3 to <=6 h) · post-surgical · Pooled by the overview from raw data; Derry 2015, codeine up to 60 mg + ibuprofen 400 mg, single dose, 0/276 vs 0/167 | RD 0 [0, 0] GRADE not reported 4 studies · 443 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical | RR 1.4 [1.2, 1.6] Moderate Downgraded: publication bias 82 studies · 7995 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral oxycodone 5 mg + paracetamol 325 mg, single dose | RR 1.6 [1.15, 2.05] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events leading to study withdrawal Timepoint not reported · post-surgical · Source review Derry 2015; codeine up to 30 mg + ibuprofen up to 400 mg, single dose, 0/610 vs 0/167; pooled by the overview from raw data | RD 0 [0, 0] GRADE not reported 777 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 183/475 vs 69/316; pooled by the overview from raw data | RR 1.76 [1.39, 2.24] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral oxycodone 5 mg + ibuprofen 100 mg, single dose | RR 0.9 [0.65, 1.15] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -2.5 [-8.5, 3.4] Low Downgraded: risk of bias, imprecision 3 studies · 713 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral codeine 60 mg + paracetamol 600/650 mg, single dose | RR 1.6 [1.3, 1.9] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral tramadol 75 mg + paracetamol 650 mg, single dose | RR 12 [6.4, 21] GRADE not reported 5 studies · 679 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral codeine 26 to 60 mg + ibuprofen 400 mg, single dose | RR 1.2 [0.75, 1.65] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: erythema Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 67/475 vs 7/316; pooled by the overview from raw data | RR 6.37 [2.96, 13.69] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: headache Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 41/475 vs 21/316; pooled by the overview from raw data | RR 1.3 [0.78, 2.16] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral codeine 60 mg + paracetamol 800/1000 mg, single dose | RR 6.3 [2.9, 14] GRADE not reported 30 studies · 192 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral tramadol 50 mg, single dose | RR 2.9 [1.6, 5.2] GRADE not reported 6 studies · 471 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: hypotension Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 11/475 vs 2/316; pooled by the overview from raw data | RR 3.66 [0.82, 16.4] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral codeine 60 mg, single dose | RR 1.5 [1.3, 1.7] GRADE not reported 33 studies · 2411 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -6 [-8, -4] Moderate Downgraded: risk of bias 2 studies · 673 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: insomnia Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 15/475 vs 16/316; pooled by the overview from raw data | RR 0.62 [0.31, 1.24] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral oxycodone 5 mg, single dose | RR 1.1 [0.8, 1.6] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: back pain Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 7/475 vs 10/316; pooled by the overview from raw data | RR 0.47 [0.18, 1.21] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral tramadol 100 mg, single dose (4 trials) | RR 3.2 [1.8, 5.6] GRADE not reported 4 studies · 304 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral oxycodone 10 mg + paracetamol 1000 mg, single dose | RR 4.9 [3.2, 7.6] GRADE not reported 2 studies · 289 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral tramadol 150 mg, single dose | RR 3.5 [2.4, 4.9] GRADE not reported 5 studies · 371 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral oxycodone 10 mg + paracetamol 650 mg, single dose | RR 1.8 [1.34, 2.25] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Derry 2015; oral codeine 26.5 to 60 mg + ibuprofen 400 mg, single dose, 78/276 vs 31/167 | RR 1.18 [0.84, 1.66] GRADE not reported 4 studies · 443 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral codeine 60 mg, single dose | RR 1.3 [0.9, 1.7] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral oxycodone 10 mg + paracetamol 1000 mg, single dose | RR 1.6 [1.25, 1.95] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral codeine 26 to 60 mg + ibuprofen 400 mg, single dose | RR 4.1 [2.8, 5.9] GRADE not reported 4 studies · 443 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Timepoint not reported · post-surgical · Source review Moore 2015 (CD011407); oral dihydrocodeine 30 mg, single dose | RR 3.4 [1.2, 9.8] GRADE not reported Studies not reported |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse events leading to study withdrawal Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg, 77/1763 vs 4/147; pooled by the overview from raw data | RR 1.61 [0.6, 4.32] GRADE not reported 7 studies · 1910 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral oxycodone 5 mg + ibuprofen 400 mg, single dose | RR 3.6 [2.6, 5.1] GRADE not reported 3 studies · 603 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral oxycodone 10 mg + paracetamol 650 mg, single dose | RR 3.9 [2.9, 5.2] GRADE not reported 10 studies · 1043 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain relief: participants with at least 50% maximum pain relief Short term (>3 to <=6 h) · post-surgical · Source review Moore 2015 (CD008659); Oral codeine 60 mg + paracetamol 600/650 mg, single dose | RR 2.6 [2.2, 3.2] GRADE not reported 17 studies · 1413 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: pyrexia Timepoint not reported · post-surgical · Source review Viscusi 2016; fentanyl iontophoretic transdermal system 40 mcg; 41/475 vs 33/316; pooled by the overview from raw data | RR 0.82 [0.58, 1.28] GRADE not reported 3 studies · 791 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: bradycardia Immediate term (<=3 h) · post-surgical · Source review Schnabel 2014 (children); nalbuphine IV or IM 3 mg/kg, 0/41 vs 0/40; pooled by the overview from raw data | RD 0 [0, 0] GRADE not reported 2 studies · 81 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Adverse event: respiratory depression Timepoint not reported · post-surgical · Source review Schnabel 2014 (children); nalbuphine IV or IM 3 mg/kg, 0/80 vs 0/77; pooled by the overview from raw data | RD 0 [0, 0] GRADE not reported 3 studies · 157 participants |
| People with acute post-surgical pain after mixed surgeries | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -6 [-7.4, -4.7] Moderate Downgraded: risk of bias 10 studies · 1083 participants |
| Women undergoing medical termination of pregnancy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · procedure-related | MD -15.3 [-31.5, 0.9] Low Downgraded: imprecision 3 studies · 87 participants |
| Women undergoing medical termination of pregnancy | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Immediate term (<=3 h) · procedure-related | RR 0.9 [0.8, 1] Moderate Downgraded: imprecision 1 study · 166 participants |
| Women undergoing medical termination of pregnancy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · procedure-related | MD -5 [-5.9, -4.1] Moderate Downgraded: imprecision 1 study · 183 participants |
| Women undergoing medical termination of pregnancy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · procedure-related | MD -12.9 [-33.2, 7.4] Low Downgraded: imprecision 3 studies · 87 participants |
| People with acute pain after abdominal surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -16.1 [-21.7, -10.4] Low Downgraded: risk of bias, inconsistency 3 studies · 479 participants |
| People with acute pain after abdominal surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Long term (>48 h) · post-surgical | MD -28.2 [-28.5, -27.9] Low Downgraded: imprecision 1 study · 90 participants |
| People with acute pain after abdominal surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -30.6 [-34.8, -26.4] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 290 participants |
| People with acute pain after abdominal surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -24.8 [-28.6, -21] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 290 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -8.8 [-14.6, -3.1] Low Downgraded: risk of bias, publication bias 14 studies · 478 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Intermediate term (>6 to <=48 h) · post-surgical | RR 1.2 [0.5, 2.6] Moderate Downgraded: imprecision 8 studies · 314 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical · Source review Zou 2016; intra-articular morphine 1 mg, single dose | MD -5 [-11.5, 1.4] GRADE not reported 7 studies · 297 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -34.4 [-80.8, 11.9] Low Downgraded: imprecision, publication bias 22 studies · 965 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical · Source review AbdelQadir 2021; intrathecal morphine, single dose | MD -20.1 [-29.3, -10.9] GRADE not reported 4 studies · 111 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical · Source review AbdelQadir 2021; intrathecal morphine, single dose | MD -30.2 [-45.7, -14.7] GRADE not reported 3 studies · 76 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -24 [-25.3, -22.8] Low Downgraded: imprecision 3 studies · 96 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical · Source review Zeng 2013; intra-articular morphine 1 to 15 mg, single dose | MD -88.9 [-95.2, -82.6] GRADE not reported 11 studies · 648 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Intermediate term (>6 to <=48 h) · post-surgical · Source review Zou 2016; intra-articular morphine 1 mg, 13/164 vs 10/150 | RR 1.09 [0.51, 2.36] GRADE not reported 8 studies · 314 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical · Source review Zou 2016; intra-articular morphine 1 mg, single dose | MD -9.5 [-11.08, -7.92] GRADE not reported 7 studies · 297 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Adverse event: pruritus Intermediate term (>6 to <=48 h) · post-surgical · Source review AbdelQadir 2021; intrathecal morphine, 6/86 vs 35/86 as printed | RR 4.82 [2.34, 9.93] GRADE not reported 5 studies · 172 participants |
| People with acute pain after knee arthroscopy | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Intermediate term (>6 to <=48 h) · post-surgical · Source review AbdelQadir 2021; 15/71 vs 7/73 | RR 2.13 [0.97, 4.69] GRADE not reported 4 studies · 144 participants |
| Adults with acute pain after bunionectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -18.2 [-23.8, -12.7] Low Downgraded: risk of bias, imprecision 1 study · 203 participants |
| Adults with acute pain after bunionectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -9.2 [-11.4, -7.1] Low Downgraded: risk of bias, imprecision 1 study · 203 participants |
| Adults with acute pain after bunionectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -20 [-26.1, -13.9] Low Downgraded: risk of bias, imprecision 1 study · 203 participants |
| People with acute pain from dermatological disease (e.g. burns) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · acute pain condition | MD -15.4 [-28.7, -2.1] Low Downgraded: imprecision 4 studies · 79 participants |
| People with acute pain from dermatological disease (e.g. burns) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD 0 [-1.4, 1.4] Low Downgraded: imprecision 2 studies · 88 participants |
| People with acute pain from dermatological disease (e.g. burns) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · acute pain condition | MD -3.3 [-34.3, 27.8] Low Downgraded: imprecision 1 study · 32 participants |
| Women with acute pain after caesarean section | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD -12.5 [-18.5, -6.5] Low Downgraded: imprecision 1 study · 60 participants |
| Women with acute labour pain | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -4.1 [-4.6, -3.6] Low Downgraded: risk of bias, imprecision 3 studies · 399 participants |
| Women with acute labour pain | Opioid analgesics | Placebo or no active treatment | Adverse event: nausea vomiting Immediate term (<=3 h) · acute pain condition · Source review Smith 2018; IM pethidine 50 or 100 mg, 12/83 vs 8/83 | RR 1.47 [0.65, 3.31] GRADE not reported 2 studies · 166 participants |
| Adults with acute renal colic | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -13 [-26.7, 0.7] Moderate Downgraded: imprecision 1 study · 100 participants |
| Women undergoing hysteroscopy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · procedure-related | MD -7.2 [-16.1, 1.7] Moderate Downgraded: imprecision 3 studies · 354 participants |
| Women undergoing hysteroscopy | Opioid analgesics | Placebo or no active treatment | Adverse events (incidence of events) Timepoint not reported · procedure-related · Source review De Silva 2020; sublingual buprenorphine, IV or oral tramadol, incidence of events 45/245 vs 5/249 | Peto OR 7.3 [3.96, 13.47] GRADE not reported 4 studies · 494 participants |
| Adults with acute pain after laparoscopic surgery with urinary catheterization | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · acute pain condition | MD -6.5 [-18.9, 5.9] Moderate Downgraded: imprecision 1 study · 137 participants |
| Adults with acute pain after laparoscopic surgery with urinary catheterization | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · acute pain condition | MD 0 [-13.1, 13.1] Moderate Downgraded: imprecision 1 study · 137 participants |
| Adults with acute pain after laparoscopic surgery with urinary catheterization | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD 2 [-10.5, 14.5] Moderate Downgraded: imprecision 1 study · 137 participants |
| Adults with acute pain after limb surgery (great saphenous vein) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD -5 [-14.8, 4.8] Moderate Downgraded: imprecision 1 study · 139 participants |
| Newborns receiving mechanical ventilation | Opioid analgesics | Placebo or no active treatment | Serious adverse events: mortality to discharge Long term (>48 h) · procedure-related · Source review Bellu 2021 (neonates); mortality to discharge, 14/88 vs 14/90 | RR 0.99 [0.52, 1.88] GRADE not reported 4 studies · 178 participants |
| Newborns receiving mechanical ventilation | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · procedure-related | MD 0 [-0.3, 0.3] Moderate Downgraded: imprecision 1 study · 150 participants |
| Newborns receiving mechanical ventilation | Opioid analgesics | Placebo or no active treatment | Serious adverse events Long term (>48 h) · procedure-related | RD 0 [-0.1, 0.1] Low Downgraded: risk of bias, imprecision 4 studies · 178 participants |
| Newborns receiving mechanical ventilation | Opioid analgesics | Placebo or no active treatment | Pain: Premature Infant Pain Profile (PIPP) score Intermediate term (>6 to <=48 h) · procedure-related · Source review Bellu 2021; morphine loading dose 100 mcg/kg plus infusion | MD -6.53 [-9, -4.07] GRADE not reported 3 studies · 963 participants |
| People with acute pain after mixed orthopaedic surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -11 [-20.7, -1.3] Very low Downgraded: risk of bias, imprecision 1 study · 80 participants |
| People with acute pain after mixed orthopaedic surgery | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -3 [-7.9, 1.9] Low Downgraded: risk of bias, imprecision 1 study · 120 participants |
| Children and adults undergoing voiding cystourethrography | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · procedure-related | MD -2.8 [-12.1, 6.5] Low Downgraded: imprecision 1 study · 69 participants |
| People with acute pain after breast surgery (mastectomy, reduction or augmentation) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD 5 [-5.1, 15.1] Low Downgraded: imprecision 1 study · 50 participants |
| People with acute pain after breast surgery (mastectomy, reduction or augmentation) | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -1.6 [-7.9, 4.7] Low Downgraded: imprecision 1 study · 33 participants |
| People with acute vaso-occlusive pain crisis in sickle cell disease | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · acute pain condition | MD 0 [-1.1, 1.1] Low Downgraded: imprecision 1 study · 49 participants |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain: Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); Fentanyl, dose not reported | MD 1.36 [-0.1, 2.82] GRADE not reported Studies not reported |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Intermediate term (>6 to <=48 h) · post-surgical | MD 17.2 [0.6, 33.8] Low Downgraded: imprecision 1 study · 30 participants |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical · Source review Martinez 2015; IV tramadol 1 mg/kg, 6 of 8 studies single dose | MD -4.14 [-8.07, -0.22] GRADE not reported 8 studies · 410 participants |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain: Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); Tramadol, dose not reported | MD 1.51 [0.86, 2.17] GRADE not reported Studies not reported |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain: Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); Morphine, dose not reported | MD 2.07 [1, 3.14] GRADE not reported Studies not reported |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Pain: McGrath face scale (FAS) Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); Tramadol, dose not reported Unresolved: the two extractors disagree on this row. | MD 0.3 [-0.89, 0.29] GRADE not reported Studies not reported |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Adverse event: postoperative complications Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); tramadol | RR 1.08 [0.69, 1.68] GRADE not reported Studies not reported |
| Children with acute pain after tonsillectomy | Opioid analgesics | Placebo or no active treatment | Adverse event: postoperative complications Intermediate term (>6 to <=48 h) · post-surgical · Source review Deng 2024 (children); morphine | RR 0.33 [0.04, 2.85] GRADE not reported Studies not reported |
| People with acute pain after photorefractive keratectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Immediate term (<=3 h) · post-surgical | MD -16 [-24.5, -7.5] Very low Downgraded: risk of bias, imprecision 1 study · 80 participants |
| People with acute pain after photorefractive keratectomy | Opioid analgesics | Placebo or no active treatment | Pain intensity (continuous, converted to 0-100 scale) Short term (>3 to <=6 h) · post-surgical | MD -25.5 [-51, 0] Very low Downgraded: risk of bias, imprecision 1 study · 80 participants |
| Adults with acute coronary syndrome | Opioid analgesics | Placebo or no active treatment | Serious adverse events Short term (>3 to <=6 h) · acute pain condition | RR 1.7 [0.7, 4.4] Moderate Downgraded: imprecision 3 studies · 2002 participants |
| Adults with acute low back pain | Opioid analgesics | Placebo or no active treatment | Disability acute pain condition | No relevant studies reported disability outcomes in the review by Cao 2024 No studies found 0 studies |
| Adults with acute low back pain | Opioid analgesics | Placebo or no active treatment | Adverse events leading to study withdrawal Long term (>48 h) · acute pain condition | RD 0.1 [0, 0.2] Low Downgraded: risk of bias, imprecision 1 study · 277 participants |
| Adults with acute low back pain | Opioid analgesics | Placebo or no active treatment | Quality of life acute pain condition | No eligible studies reported quality of life outcomes in the review by Cao 2024 No studies found 0 studies |
| Adults with acute low back pain | Opioid analgesics | Placebo or no active treatment | Serious adverse events Long term (>48 h) · acute pain condition | RD 0 [0, 0] Low Downgraded: risk of bias, imprecision 1 study · 277 participants |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Summed pain intensity difference at 48 minutes (SPID48) Long term (>48 h) · acute pain condition · Source review Xiao 2017; oral tapentadol IR 75 mg | MD 82.89 [60.62, 105.16] GRADE not reported 7 studies · 1437 participants |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Serious adverse events Long term (>48 h) · acute pain condition | RD 0 [-0.1, 0] Low Downgraded: risk of bias, imprecision 2 studies · 555 participants |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Summed pain intensity difference at 48 minutes (SPID48) Long term (>48 h) · acute pain condition · Source review Xiao 2017; oral tapentadol IR 100 mg | MD 89.03 [20.06, 158] GRADE not reported 3 studies · 630 participants |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Quality of life acute pain condition | No eligible studies reported quality of life outcomes in the review by Piirainen 2022 No studies found 0 studies |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Summed pain intensity difference at 48 minutes (SPID48) Long term (>48 h) · acute pain condition · Source review Xiao 2017; oral tapentadol IR 50 mg | MD 70.76 [49.9, 91.62] GRADE not reported 6 studies · 1247 participants |
| People with acute pain of mixed conditions | Opioid analgesics | Placebo or no active treatment | Adverse events (participants with at least one) Immediate term (<=3 h) · acute pain condition | RD 0 [-0.1, 0.1] Low Downgraded: imprecision 1 study · 33 participants |
| Neonates with post-operative pain | Opioid analgesics | Placebo or no active treatment | Serious adverse events Long term (>48 h) · post-surgical | RD 0 [-0.1, 0] Low Downgraded: imprecision 1 study · 71 participants |
| Adults with propofol injection pain | Opioid analgesics | Placebo or no active treatment | Pain: frequency of pain events Immediate term (<=3 h) · acute pain condition · Source review Bakhtiari 2021; IV tramadol, ketamine, remifentanil, butorphanol, nalbuphine | RR 0.39 [0.28, 0.54] GRADE not reported 13 studies · 1060 participants |
| Newborns undergoing therapeutic hypothermia | Opioid analgesics | Placebo or no active treatment | Pain intensity acute pain condition | Cochrane review (Backe 2022) found 0 studies No studies found 0 studies |
| Adults and children undergoing elective craniotomy | Opioid analgesics | Placebo or no active treatment | Pain intensity post-surgical | Cochrane review (Mestdagh 2023) found 0 eligible studies No studies found 0 studies |
| Children with chemotherapy-induced severe mucositis | Opioid analgesics | Placebo or no active treatment | Pain intensity acute pain condition | Cochrane review (Walker 2022) found 0 eligible studies No studies found 0 studies |
| Adults with acute pain in the prehospital setting | Opioid analgesics | Placebo or no active treatment | Pain intensity acute pain condition | Review (Hyldmo 2024) included 7 trials, 0 eligible No studies found 0 studies |
| Adults with acute pain presenting to the emergency department | Opioid analgesics | Placebo or no active treatment | Pain intensity acute pain condition Unresolved: the two extractors disagree on this row. | Review (Payami 2018) included 8 trials, 0 eligible No studies found 0 studies |
Included primary studies 60
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abdel Shaheed 2019 Efficacy and Safety of Low-dose Codeine-containing Combination Analgesics for Pain: Systematic Review and Meta-Analysis. PMID:31318725 | 2019 | this review only | not stated | not extracted yet |
| AbdelQadir 2021 Efficacy and safety of intrathecal morphine in total knee arthroplasty: A systematic review and meta-analysis. PMID:34714541 | 2021 | this review only | not stated | not extracted yet |
| Albaqami 2023 Buprenorphine for acute post-surgical pain: A systematic review and meta-analysis. PMID:37032687 | 2023 | this review only | not stated | not extracted yet |
| Alimy 2024 Conservative Treatments in the Management of Acute Painful Vertebral Compression Fractures: A Systematic Review and Network Meta-Analysis. PMID:39240564 | 2024 | this review only | not stated | not extracted yet |
| Ardila 2024 Perioperative analgesic efficacy and adverse events of fentanyl in dentistry: A systematic review. PMID:37837245 | 2024 | this review only | not stated | not extracted yet |
| Backe 2022 Pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia. PMID:36354070 | 2022 | this review only | not stated | not extracted yet |
| Bakhtiari 2021 Pharmacological control of pain during propofol injection: a systematic review and meta-analysis. PMID:33896305 | 2021 | this review only | not stated | not extracted yet |
| Bellu 2021 Opioids for newborn infants receiving mechanical ventilation. PMID:33729556 | 2021 | this review only | not stated | not extracted yet |
| Cao 2024 Paracetamol Combination Therapy for Back Pain and Osteoarthritis: A Systematic Review and Meta-Analyses. PMID:38937394 | 2024 | this review only | not stated | not extracted yet |
| Cozowicz 2018 Opioids for Acute Pain Management in Patients With Obstructive Sleep Apnea: A Systematic Review. PMID:29958218 | 2018 | this review only | not stated | not extracted yet |
| Davis 2011 Fentanyl for breakthrough pain: a systematic review. PMID:21797660 | 2011 | this review only | not stated | not extracted yet |
| De Grunt 2024 Parenteral, Non-Intravenous Analgesia in Acute Traumatic Pain-A Narrative Review Based on a Systematic Literature Search. PMID:38731088 | 2024 | this review only | not stated | not extracted yet |
| De Silva 2020 Analgesia for Office Hysteroscopy: A Systematic Review and Meta-analysis. PMID:31982584 | 2020 | this review only | not stated | not extracted yet |
| Deeks 2019 Sufentanil 30 µg Sublingual Tablet: A Review in Acute Pain. PMID:30887417 | 2019 | this review only | not stated | not extracted yet |
| Deng 2024 Comparative Effectiveness of Analgesia for Early Pain Management After Pediatric Tonsillectomy: A Systematic Review and Network… PMID:39705169 | 2025 | this review only | not stated | not extracted yet |
| Derry 2015 Single dose oral ibuprofen plus codeine for acute postoperative pain in adults. PMID:25927097 | 2015 | this review only | not stated | not extracted yet |
| Deussen 2020 Relief of pain due to uterine cramping/involution after birth. PMID:33078388 | 2020 | this review only | not stated | not extracted yet |
| Dhillion 2010 Tramadol/paracetamol fixed-dose combination: a review of its use in the management of moderate to severe pain. PMID:20701403 | 2010 | this review only | not stated | not extracted yet |
| Du 2013 Butorphanol prevents morphine-induced pruritus without increasing pain and other side effects: a systematic review of randomized… PMID:23813290 | 2013 | this review only | not stated | not extracted yet |
| Duarte 2019 Morphine in acute coronary syndrome: systematic review and meta-analysis. PMID:30878985 | 2019 | this review only | not stated | not extracted yet |
| Elango 2021 DOI:10.4103/jpp.jpp_116_21 | NR | this review only | not stated | not extracted yet |
| Garcia-Perdomo 2017 Pharmacologic interventions to treat renal colic pain in acute stone episodes: Systematic review and meta-analysis. PMID:28651994 | 2017 | this review only | not stated | not extracted yet |
| Gavriilidis 2019 To Use or Not to Use Opioid Analgesia for Acute Abdominal Pain Before Definitive Surgical Diagnosis? A Systematic Review and Network… PMID:30701004 | 2019 | this review only | not stated | not extracted yet |
| Gounari 2023 Efficacy and safety of parenteral and local application of tramadol in mandibular third molar extraction: a qualitative systematic review… PMID:37640978 | 2024 | this review only | not stated | not extracted yet |
| Gutierrez 2021 Topical opioid use in dermatologic disease: A systematic review. PMID:34605133 | 2021 | this review only | not stated | not extracted yet |
| Hanna and Senderovich 2021 Methadone in Pain Management: A Systematic Review. PMID:32599153 | 2021 | this review only | not stated | not extracted yet |
| Hansen 2012 Intranasal fentanyl in the treatment of acute pain--a systematic review. PMID:22260169 | 2012 | this review only | not stated | not extracted yet |
| Huang 2022 Sufentanil for Spinal Analgesia during Cesarean Section Delivery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PMID:36105787 | 2022 | this review only | not stated | not extracted yet |
| Hyldmo 2024 Inhaled analgesics for the treatment of prehospital acute pain-A systematic review. PMID:39327650 | 2024 | this review only | not stated | not extracted yet |
| Jackson and Kapp 2011 Pain control in first-trimester and second-trimester medical termination of pregnancy: a systematic review. PMID:21237336 | 2011 | this review only | not stated | not extracted yet |
| Jones 2024 Opioids for Acute Musculoskeletal Pain: A Systematic Review with Meta-Analysis. PMID:38451443 | 2024 | this review only | not stated | not extracted yet |
| Joshi 2015 Optimal pain management for radical prostatectomy surgery: what is the evidence? PMID:26530113 | 2015 | this review only | not stated | not extracted yet |
| Kinoshita 2023 Systemic opioids versus other analgesics and sedatives for postoperative pain in neonates. PMID:36870076 | 2023 | this review only | not stated | not extracted yet |
| Leppert 2014 Oxycodone/naloxone in the management of patients with pain and opioid-induced bowel dysfunction. PMID:24020972 | 2014 | this review only | not stated | not extracted yet |
| Luxey 2024 Acute pain management after vaginal delivery with perineal tears or episiotomy. PMID:38772634 | 2025 | this review only | not stated | not extracted yet |
| Maeßen 2023 Pain management after cardiac surgery via median sternotomy: A systematic review with procedure-specific postoperative pain management… PMID:37501517 | 2023 | this review only | not stated | not extracted yet |
| Maroni 2023 Fetal, Preterm, and Term Neonate Exposure to Remifentanil: A Systematic Review of Efficacy and Safety. PMID:37541994 | 2023 | this review only | not stated | not extracted yet |
| Martinez 2015 Effect of combining tramadol and morphine in adult surgical patients: a systematic review and meta-analysis of randomized trials. PMID:25516276 | 2015 | this review only | not stated | not extracted yet |
| Mestdagh 2023 Pain management after elective craniotomy: A systematic review with procedure-specific postoperative pain management (PROSPECT)… PMID:37417808 | 2023 | this review only | not stated | not extracted yet |
| Miroshnychenko 2023 Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis. PMID:36631957 | 2023 | this review only | not stated | not extracted yet |
| Moore 2015 (CD008659) Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. PMID:26414123 | 2015 | this review only | not stated | not extracted yet |
| Moore 2015 (CD011407) Adverse events associated with single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. PMID:26461263 | 2015 | this review only | not stated | not extracted yet |
| Naghipour 2020 Comparison of Ketamine and Tramadol in Management of Acute Pain; a Systematic Review. PMID:33134964 | 2020 | this review only | not stated | not extracted yet |
| Payami 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Payami 2018 Protein-DNA and protein-hormone interactions in prealbumin: a model of the thyroid hormone nuclear receptor? PMID:201845 | 1977 | this review only | not stated | not extracted yet |
| Piirainen 2022 Epidural Oxycodone for Acute Pain. PMID:35631469 | 2022 | this review only | not stated | not extracted yet |
| Poonai 2014 Opioid analgesia for acute abdominal pain in children: A systematic review and meta-analysis. PMID:25377394 | 2014 | this review only | not stated | not extracted yet |
| Renner 2010 Pain control in first-trimester surgical abortion: a systematic review of randomized controlled trials. PMID:20399943 | 2010 | this review only | not stated | not extracted yet |
| Schnabel 2014 Nalbuphine for postoperative pain treatment in children. PMID:25079857 | 2014 | this review only | not stated | not extracted yet |
| Serra 2023 Intranasal Fentanyl for Acute Pain Management in Children, Adults and Elderly Patients in the Prehospital Emergency Service and in the… PMID:37048692 | 2023 | this review only | not stated | not extracted yet |
| Smith 2018 Parenteral opioids for maternal pain management in labour. PMID:29870574 | 2018 | this review only | not stated | not extracted yet |
| Steinberg 2017 Preemptive analgesia for postoperative hysterectomy pain control: systematic review and clinical practice guidelines. PMID:28351670 | 2017 | this review only | not stated | not extracted yet |
| Telfer 2024 The acute pain crisis in sickle cell disease: What can be done to improve outcomes? PMID:38553339 | 2024 | this review only | not stated | not extracted yet |
| Thirunavukarasu 2022 Analgesia for retinopathy of prematurity screening: A systematic review. PMID:35703418 | 2022 | this review only | not stated | not extracted yet |
| Viscusi 2016 The Efficacy and Safety of the Fentanyl Iontophoretic Transdermal System (IONSYS®) in the Geriatric Population: Results of a Meta-Analysis… PMID:27785733 | 2016 | this review only | not stated | not extracted yet |
| Viscusi 2024 Present and Future of Pharmacological Management for Acute Moderate-to-Severe Postoperative, Traumatic, or Musculoskeletal Pain in Europe:… PMID:39305453 | 2024 | this review only | not stated | not extracted yet |
| Walker 2022 Intravenous opioids for chemotherapy-induced severe mucositis pain in children: Systematic review and single-center case series of… PMID:34731511 | 2022 | this review only | not stated | not extracted yet |
| Xiao 2017 Efficacy and Safety of Tapentadol Immediate Release Assessment in Treatment of Moderate to Severe Pain: A Systematic Review and… PMID:27516366 | 2017 | this review only | not stated | not extracted yet |
| Zeng 2013 Single-dose intra-articular morphine after arthroscopic knee surgery: a meta-analysis of randomized placebo-controlled studies. PMID:23768848 | 2013 | this review only | not stated | not extracted yet |
| Zou 2016 Single dose intra-articular morphine for pain control after knee arthroscopy. PMID:27140500 | 2016 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Participants of any age with any acute (<3 months) non-malignant painful condition | 59 reviews (n=59): 24 on acute pain conditions, 29 on post-surgical pain, 6 on acute pain with procedural techniques; 9 reviews in children only; 9 additional trials from citation tracking |
| Intervention | Opioid analgesics (single ingredient or in combination), any dose, formulation, delivery route or regimen | Opioid analgesics including morphine, oxycodone, tramadol, codeine, fentanyl, buprenorphine, tapentadol and combinations; daily dose 0.2 to 180 MME/day |
| Comparison | Placebo or no active treatment | Placebo or no active treatment |
| Outcomes | Primary: pain intensity (continuous). Secondary: other pain outcomes, disability, quality of life, harms (serious adverse events, adverse events, adverse events leading to withdrawal) | Pain intensity, categorical pain outcomes, disability, quality of life (no eligible studies), serious adverse events, adverse events, adverse events leading to withdrawal |
| Study designs | Systematic reviews (with or without meta-analysis) of randomized controlled trials published since 2010 | Systematic reviews of RCTs (n=59 reviews; 11 Cochrane reviews); 86 trials at immediate term, 42 short term, 75 intermediate term, 5 long term |
| Timing | Immediate (<=3 h), short (>3 to <=6 h), intermediate (>6 to <=48 h) and long term (>48 h) after administration | Immediate (n=86 trials; 8407 participants), short (n=42; 4998), intermediate (n=75; 7470), long (n=5; 1002) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Yes | Yes | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Moderate | Moderate | yes |