Comparing analgesic efficacy of non-steroidal anti-inflammatory drugs given by different routes in acute and chronic pain: a qualitative systematic review

Acta Anaesthesiologica Scandinavica
M R TramèrH J McQuay

Abstract

To test the evidence for a difference in analgesic efficacy and adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) given by different routes. Systematic review of published randomised controlled trials. Relevant trials were comparisons of the same drug given by different routes. Presence of internal sensitivity was sought as a validity criterion. Analgesic and adverse effect outcomes were summarised, and synthesised qualitatively. In 26 trials (2225 analysed patients), 8 different NSAIDs were tested in 58 comparisons. Fifteen trials (58%) compared the same drug by different routes. Drugs were given by intravenous, intramuscular, intrawound, rectal and oral routes in postoperative pain (14 trials), renal colic (4), acute musculoskeletal pain (1), dysmenorrhoea (1), and rheumatoid arthritis (6). Five of the 15 direct comparisons were invalid because they reported no difference between routes but without evidence of internal sensitivity. In all 3 direct comparisons in renal colic, intravenous NSAID had a faster onset of action than intramuscular or rectal. In 1 direct comparison in dysmenorrhoea, oral NSAID was better than rectal. In the 5 direct comparisons in postoperative pain, results were inconsistent. In 1 dir...Continue Reading

References

Feb 1, 1992·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·T HyrkäsG Hampf
Jul 1, 1970·Annals of the Rheumatic Diseases·E C HuskissonF D Hart
Oct 1, 1980·British Journal of Clinical Pharmacology·N BaberT Littler
Aug 1, 1995·Annals of Emergency Medicine·M A TurturroD C Seaberg
Sep 1, 1995·Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association·J N Katz, V Gall
Jul 5, 1995·JAMA : the Journal of the American Medical Association·D W BatesR Hallisey
Jan 7, 1995·BMJ : British Medical Journal·J Mitchell
Dec 1, 1993·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P Morley-ForsterM J Cook
Sep 1, 1995·Journal of Clinical Anesthesia·T J ParkeA S Rice
Jul 6, 1996·BMJ : British Medical Journal·B JonesA F Ebbutt
Nov 1, 1995·Anaesthesia·H A Vyvyan, Z Hanafiah
Mar 1, 1996·Acta Anaesthesiologica Scandinavica·B Ben-DavidL Gaitini
Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Jan 1, 1996·European Journal of Anaesthesiology·J JakobssonS Davidson
Feb 1, 1997·British Journal of Obstetrics and Gynaecology·D CarrollA Moore
May 24, 1997·BMJ : British Medical Journal·H McQuayD Justins

❮ Previous
Next ❯

Citations

Aug 28, 2009·Transactions of the Royal Society of Tropical Medicine and Hygiene·T SeylerM Murhekar
Jan 11, 2001·Pharmacology & Therapeutics·R D MacPherson
Nov 5, 2003·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Elina NikanneHannu Kokki
Mar 31, 1999·Journal of Pain and Symptom Management·H J McQuayR A Moore
Aug 16, 2000·Journal of Clinical Epidemiology·T J KaptchukW B Stason
Jan 7, 2000·Journal of Clinical Anesthesia·F M BardiauJ G Boogaerts
Dec 12, 2002·Trends in Endocrinology and Metabolism : TEM·Gordon Blackburn-Munro, Ruth Blackburn-Munro
Mar 4, 2000·European Journal of Pain : EJP·S L CollinsP J Wiffen
Dec 9, 2004·BMC Emergency Medicine·Tunji A LasoyeNadeem Nayeem
Aug 6, 2011·The Journal of Veterinary Medical Science·Kenji TakataHiroshi Satoh
Apr 26, 2007·Clinical Medicine & Research·C K S OngR A Seymour
May 15, 2008·Cerebrovascular Diseases·UNKNOWN European Stroke Organisation (ESO) Executive Committee, UNKNOWN ESO Writing Committee
Sep 13, 2006·European Neurology·T HenzeUNKNOWN Multiple Sclerosis Therapy Consensus Group of the German Multiple Sclerosis Society
Dec 6, 2006·Journal of Endourology·S MicaliG Bianchi
Aug 9, 2005·Der Internist·D Rothstein, M Zenz
Jun 16, 2007·European Journal of Clinical Pharmacology·Juan Sánchez-CarpenaUNKNOWN Dexketoprofen Renal Colic Study Group
Oct 4, 2002·The New England Journal of Medicine·Charles B Berde, Navil F Sethna
Feb 13, 2004·The New England Journal of Medicine·Joel M H Teichman
Feb 23, 2010·Journal of Anesthesia·Yoko KawaguchiKazuyoshi Hirota
Jun 1, 2013·Pain and Therapy·Mehul J DesaiShawnjeet Saini
Jan 16, 2016·Zeitschrift für Rheumatologie·W W BoltenUNKNOWN Kommission Pharmakotherapie der DGRh
May 12, 2007·Expert Review of Neurotherapeutics·Gaetan MoiseChristopher J Winfree
Jan 10, 2016·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Matteo FornaiCarmelo Scarpignato
Feb 7, 2013·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·Somboon ThienthongWalairat Kemthong
Sep 12, 2009·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·UNKNOWN American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons
Oct 13, 2009·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Mark Helfand, Michele Freeman
Feb 7, 2012·The American Journal of Emergency Medicine·Erdem CevikScott Travis Youngquist
Mar 15, 2011·The Journal of Pain : Official Journal of the American Pain Society·Lori Reisner
Oct 19, 2010·Gastroenterology Clinics of North America·Carmelo Scarpignato, Richard H Hunt
Sep 8, 2009·European Urology·Magnus FallUNKNOWN European Association of Urology
Feb 4, 2009·Critical Reviews in Oncology/hematology·Carla Ripamonti, Elena Bandieri
Jun 27, 2006·Child and Adolescent Psychiatric Clinics of North America·Renée McCulloch, John J Collins
Jul 4, 2009·Journal of the American Geriatrics Society·UNKNOWN American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons
Jan 19, 2008·Periodontology 2000·Cliff K S Ong, Robin A Seymour
May 23, 2014·European Journal of Pain : EJP·R A MooreP J Wiffen
Mar 20, 2014·Journal of Clinical Periodontology·Rino Burkhardt, Niklaus P Lang
Sep 1, 2004·Clinical Therapeutics·Ivan PavlikUNKNOWN Evaluation of Cizolirtine Citrate to Treat Renal Colic Pain Study Group
May 29, 2004·Trends in Pharmacological Sciences·Gordon Blackburn-Munro
Sep 6, 2006·Annals of Emergency Medicine·Basmah SafdarGail D'Onofrio
Mar 21, 2006·Best Practice & Research. Clinical Rheumatology·Debajit Sen, Deborah Christie

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