title: Single dose oral sulindac for acute postoperative pain in adults.
abstract: BACKGROUND
  Sulindac is a non-steroidal anti-inflammatory drug (NSAID) licensed for use in rheumatic disease and other musculoskeletal disorders in the UK, and widely available in other countries worldwide. This review sought to evaluate the efficacy and safety of oral sulindac in acute postoperative pain, using clinical studies of patients with established pain, and with outcomes measured primarily over 6 hours using standard methods. This type of study has been used for many decades to establish that drugs have analgesic properties.
  
  
  OBJECTIVE
  To assess the efficacy of single dose oral sulindac in acute postoperative pain, and any associated adverse events.
  
  
  METHODS
  We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies up to June 2009.
  
  
  METHODS
  Randomised, double-blind, placebo-controlled clinical trials of oral sulindac for relief of acute postoperative pain in adults.
  
  
  METHODS
  Two review authors independently assessed trial quality and extracted data. We planned to use area under the "pain relief versus time" curve to derive the proportion of participants with meloxicam experiencing least 50% pain relief over 4 to 6 hours, using validated equations; to use number needed to treat to benefit (NNT); the proportion of participants using rescue analgesia over a specified time period; time to use of rescue analgesia; information on adverse events and withdrawals.
  
  
  RESULTS
  No studies were identified by the searches that examined oral sulindac in patients with established postoperative pain.
  
  
  CONCLUSIONS
  In the absence of evidence of efficacy, at present, for oral sulindac in acute postoperative pain, its use in this indication is not justified. Because trials clearly demonstrating analgesic efficacy in the most basic of acute pain studies is lacking, use in other indications should be evaluated carefully. Given the large number of available drugs of this and similar classes, there is no urgent research agenda.
authors.affiliation: Pain Research and Nuffield Department of Anaesthetics, University of Oxford, West Wing (Level 6), John Radcliffe Hospital, Oxford, Oxfordshire, UK, OX3 9DU.
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Moore
authors.forename: Sheena
authors.initials: S
authors.lastname: Derry
authors.forename: Henry J
authors.initials: HJ
authors.lastname: McQuay
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D013467:Sulindac / Q000008:administration & dosage*
chemical_list: D000700:Analgesics; D016861:Cyclooxygenase Inhibitors; D013467:Sulindac