What proportion of people with postoperative pain experience adverse events with single‐dose oral analgesics?

Abstract

Compared with placebo in adults with at least moderate‐intensity postoperative pain, people taking one of these analgesics at a single dose had greater rates of adverse events: aspirin 600/650 mg or 920/1000 mg, diflunisal 1000 mg, ibuprofen 200 mg plus caffeine 100 mg, dihydrocodeine 30 mg, paracetamol (any dose) + codeine 30 or 60 mg, and paracetamol 325 to 1000 mg plus oxycodone 5 to 10 mg. However, four analgesics led to lower rates of adverse events than placebo: ibuprofen 200 or 400 mg and ibuprofen 200 to 400 mg plus paracetamol 500 to 1000 mg, respectively. Trial authors typically reported serious adverse events as absent; such events were too few for statistical evaluation. Reviewers stated that trial results should be treated with caution, as the method used to collect adverse event data influences adverse event reporting rates; patient diaries yield significantly more adverse events when compared with other forms of assessment.