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Single-dose oral naproxen for acute postoperative pain: a quantitative systematic review.

Mason L, Edwards JE, Moore RA, McQuay HJ - BMC Anesthesiol (2003)

Bottom Line: This review aims to assess the efficacy, safety and duration of action of a single oral dose of naproxen/naproxen sodium for moderate to severe acute postoperative pain in adults, compared with placebo.The percentage of patients with any adverse event, number-needed-to-harm, and time to remedication were also calculated.A low incidence of adverse events was found, although these were not reported consistently.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pain Research and the Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, The Churchill, Headington, Oxford, OX3 7LJ, UK. andrew.moore@pru.ox.ac.uk

ABSTRACT
BACKGROUND: Naproxen and naproxen sodium are non-steroidal anti-inflammatory drugs used in a variety of painful conditions, including the treatment of postoperative pain. This review aims to assess the efficacy, safety and duration of action of a single oral dose of naproxen/naproxen sodium for moderate to severe acute postoperative pain in adults, compared with placebo. METHODS: The Cochrane Library (issue 4 2002), EMBASE, PubMed, MEDLINE and an in-house database were searched for randomised, double blind, placebo controlled trials of a single dose of orally administered naproxen or naproxen sodium in adults with acute postoperative pain. Pain relief or pain intensity data were extracted and converted into dichotomous information to give the number of patients with at least 50% pain relief over 4 to 6 hours. Relative benefit and number-needed-to-treat were then calculated. The percentage of patients with any adverse event, number-needed-to-harm, and time to remedication were also calculated. RESULTS: Ten trials with 996 patients in met the inclusion criteria. Six trials compared naproxen sodium 550 mg (252 patients) with placebo (248 patients); the NNT for at least 50% pain relief over six hours was 2.6 (95% confidence interval 2.2 to 3.2). There was no significant difference between the number of patients experiencing any adverse event on treatment compared with placebo. Weighted mean time to remedication was 7.6 hours for naproxen sodium 550 mg (206 patients) and 2.6 hours for placebo (205 patients). Four other trials used lower doses. CONCLUSION: A single oral dose of naproxen sodium 550 mg is an effective analgesic in the treatment of acute postoperative pain. A low incidence of adverse events was found, although these were not reported consistently.

No MeSH data available.


Related in: MedlinePlus

L'Abbé plot. Percentage of patients with at least 50% pain relief in placebo controlled clinical trials of naproxen sodium 550 mg. Each circle represents one included trial.
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Figure 1: L'Abbé plot. Percentage of patients with at least 50% pain relief in placebo controlled clinical trials of naproxen sodium 550 mg. Each circle represents one included trial.

Mentions: The mean response rate (percentage of patients with at least 50% pain relief) for naproxen sodium was 50% (127 patients out of 252), ranging from 30% to 72% in individual trials (Figure 1). The mean placebo response rate was 12% (30 patients out of 248), ranging from 6% to 19%.


Single-dose oral naproxen for acute postoperative pain: a quantitative systematic review.

Mason L, Edwards JE, Moore RA, McQuay HJ - BMC Anesthesiol (2003)

L'Abbé plot. Percentage of patients with at least 50% pain relief in placebo controlled clinical trials of naproxen sodium 550 mg. Each circle represents one included trial.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC212403&req=5

Figure 1: L'Abbé plot. Percentage of patients with at least 50% pain relief in placebo controlled clinical trials of naproxen sodium 550 mg. Each circle represents one included trial.
Mentions: The mean response rate (percentage of patients with at least 50% pain relief) for naproxen sodium was 50% (127 patients out of 252), ranging from 30% to 72% in individual trials (Figure 1). The mean placebo response rate was 12% (30 patients out of 248), ranging from 6% to 19%.

Bottom Line: This review aims to assess the efficacy, safety and duration of action of a single oral dose of naproxen/naproxen sodium for moderate to severe acute postoperative pain in adults, compared with placebo.The percentage of patients with any adverse event, number-needed-to-harm, and time to remedication were also calculated.A low incidence of adverse events was found, although these were not reported consistently.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pain Research and the Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, The Churchill, Headington, Oxford, OX3 7LJ, UK. andrew.moore@pru.ox.ac.uk

ABSTRACT
BACKGROUND: Naproxen and naproxen sodium are non-steroidal anti-inflammatory drugs used in a variety of painful conditions, including the treatment of postoperative pain. This review aims to assess the efficacy, safety and duration of action of a single oral dose of naproxen/naproxen sodium for moderate to severe acute postoperative pain in adults, compared with placebo. METHODS: The Cochrane Library (issue 4 2002), EMBASE, PubMed, MEDLINE and an in-house database were searched for randomised, double blind, placebo controlled trials of a single dose of orally administered naproxen or naproxen sodium in adults with acute postoperative pain. Pain relief or pain intensity data were extracted and converted into dichotomous information to give the number of patients with at least 50% pain relief over 4 to 6 hours. Relative benefit and number-needed-to-treat were then calculated. The percentage of patients with any adverse event, number-needed-to-harm, and time to remedication were also calculated. RESULTS: Ten trials with 996 patients in met the inclusion criteria. Six trials compared naproxen sodium 550 mg (252 patients) with placebo (248 patients); the NNT for at least 50% pain relief over six hours was 2.6 (95% confidence interval 2.2 to 3.2). There was no significant difference between the number of patients experiencing any adverse event on treatment compared with placebo. Weighted mean time to remedication was 7.6 hours for naproxen sodium 550 mg (206 patients) and 2.6 hours for placebo (205 patients). Four other trials used lower doses. CONCLUSION: A single oral dose of naproxen sodium 550 mg is an effective analgesic in the treatment of acute postoperative pain. A low incidence of adverse events was found, although these were not reported consistently.

No MeSH data available.


Related in: MedlinePlus