Meta-analysis of the effectiveness of nonsteroidal anti-inflammatory drugs in a standardized pain model.
A comprehensive meta-analysis using strict inclusion criteria examined 8 studies comparing the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) and codeine-based oral analgesics for treating moderate to severe oral surgery pain. The studies involved 1,163 patients, drawn from a literature search of more than 300 studies published since 1990. Of the 8, 5 showed significantly better outcomes (P < .05) with NSAIDs, while 3 showed no differences in outcomes (P > .05). Adverse reactions were greater in the opiate group (P < .001). Data from the 8 studies were subjected to standardized data transformation and analysis procedures using preselected pain measurement inventories. An oral surgery pain model was used because it is relatively free of confounding variables, thereby leading to clearer results. Results of the meta-analysis revealed that NSAIDs were either as effective or more effective than codeine-based analgesics for treating the moderate to severe pain associated with oral surgery. NSAIDs also were associated with fewer complications. Based on this analysis, NSAIDs should be considered for the control of postoperative oral surgery pain. Generalizability to other forms of postoperative pain remains speculative.
Biddle
Chuck
C
Virginia Commonwealth University/Medical College of Virginia, Richmond, Va., USA.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal