Is it useful to add acetaminophen to high-potency opioids in cancer-related pain?

Medwave
Oscar Corsi, Pedro E Pérez-Cruz

Abstract

Pain is one of the most frequent and relevant symptoms in cancer patients. The World Health Organization's analgesic ladder proposes the use of strong opioids associated with adjuvants such as acetaminophen or nonsteroidal anti-inflammatory drugs in step III. However, it is unclear whether adding acetaminophen to an analgesic regimen based on strong opioids has any benefit in cancer patients with moderate to severe pain. To answer this question we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified two systematic reviews including five randomized trials overall. We extracted data and generated a summary of findings table using the GRADE approach. We concluded that adding acetaminophen to strong opioids might make little or no difference in improving pain management in cancer patients.

References

Aug 18, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Martin StocklerDavid Warr
May 19, 2007·Journal of Pain and Symptom Management·Saskia C C M TeunissenAlexander de Graeff
Oct 6, 2007·Pain·Marieke H J van den Beuken-van EverdingenJacob Patijn
Apr 4, 2009·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Buket TasmaciogluAbdullah Sonsuz
May 8, 2009·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Daniel I G Cubero, Auro del Giglio
Feb 4, 2012·The Lancet Oncology·Augusto CaraceniUNKNOWN European Association for Palliative Care (EAPC)
Feb 12, 2013·Critical Reviews in Oncology/hematology·Sebastiano Mercadante, Antonino Giarratano

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