Patient response to pain relief variable

NO SINGLE oral analgesic or dose of analgesic produces adequate pain relief in all patients, researchers say after analysing 35 Cochrane reviews on interventions for acute post-operative pain.

After producing efficacy estimates for 46 different drug/dose combinations, the researchers from the Oxford Pain Research Unit at Oxford University found the most efficacious pain relievers achieved good outcomes for 70% of patients with the least useful drug benefiting only 30%.

The drug/dose combinations with a low number needed to treat were: ibuprofen 400 mg, diclofenac 50 mg, etoricoxib 120 mg, codeine 60 mg + paracetamol 1000 mg, celecoxib 400 mg, and naproxen 500/550 mg.

The drugs with long duration of action (>8 hours) included etoricoxib 120 mg, oxycodone 10 mg + paracetamol 650 mg, naproxen 500/550 mg, and celecoxib 400 mg. 

Drugs for which there was evidence of lack of effect included aspirin 500 mg, and oxycodone 5 mg, the