NSAIDS Superior to Codeine for Reducing Postoperative Pain

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen reduce pain more effectively and have fewer side effects compared to codeine, a commonly prescribed opioid after outpatient surgery, according to new research published in CMAJ (Canadian Medical Association Journal).

"In all surgery types, subgroups and outcome time points, NSAIDs were equal or superior to codeine for postoperative pain," writes Dr. Matthew Choi, Associate Professor of Surgery, McMaster University, with coauthors.

‘Physicians can prescribe common painkillers for postoperative pain relief instead of opioids.’

A systematic review and meta-analysis of 40 high-quality randomized controlled trials (RCTs) involving more than 5100 adults was done to compare pain levels and safety of medications containing codeine, such as Tylenol #3, with NSAIDs.

Results showed that patients who used NSAIDs had lower pain scores at 6 and 12 hours after treatment than patients taking codeine.

"We found that patients randomized to NSAIDs following outpatient surgical procedures reported better pain scores, better global assessment scores, fewer adverse effects and no difference in bleeding events, compared with those receiving codeine," write the authors.

Codeine is used commonly to relieve postoperative pain management. But it is linked to various side effects and potential misuse or addiction. Alternatives such as NSAIDs can help reduce opioid use in patients after dental and surgical procedures.

"These findings are of general importance to any clinician performing painful medical procedures. The various trials in our meta-analysis evaluated a range of procedures, different NSAID types and various degrees of acetaminophen administration."

The authors conclude that their findings "strengthen existing evidence and are broadly generalizable to patients across surgical disciplines."



Source: Medindia