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• W2779043310 abstract "Postoperative administration of non-steroidal anti-inflammatory drugs (NSAIDs) reduces patient opioid requirements and, in turn, reduces the incidence and severity of opioid-induced adverse events (AEs).To assess the analgesic efficacy and adverse effects of single-dose intravenous diclofenac, compared with placebo or an active comparator, for moderate to severe postoperative pain in adults.We searched the following databases without language restrictions: the Cochrane Central Register of Controlled Trials (Cochrane Register of Studies Online), MEDLINE, and Embase on 22 May 2018. We checked clinical trials registers and reference lists of retrieved articles for additional studies.We included randomized trials that compared a single postoperative dose of intravenous diclofenac with placebo or another active treatment, for treating acute postoperative pain in adults following any surgery.We used standard methodological procedures expected by Cochrane. Two review authors independently considered trials for review inclusion, assessed risk of bias, and extracted data.Our primary outcome was the number of participants in each arm achieving at least 50% pain relief over a four- and six-hour period.Our secondary outcomes were time to, and number of participants using rescue medication; withdrawals due to lack of efficacy, AEs, and for any cause; and number of participants experiencing any AE, serious AEs (SAEs), and NSAID-related AEs. We performed a post hoc analysis of opioid-related AEs, to enable indirect comparisons with other analyses of postoperative analgesics.For subgroup analysis, we planned to analyze different doses and formulations of parenteral diclofenac separately.We assessed the overall quality of the evidence for each outcome using GRADE and created two 'Summary of findings' tables.We included eight studies, involving 1756 participants undergoing various surgeries (dental, mixed minor, abdominal, and orthopedic), with 20 to 175 participants receiving intravenous diclofenac in each study. Mean study population ages ranged from 24.5 years to 54.5 years. Intravenous diclofenac doses varied among and within studies, ranging from 3.75 mg to 75 mg. Five studies assessed newer formulations of parenteral diclofenac that could be administered as an undiluted intravenous bolus. Most studies had an unclear risk of bias for several domains and a high risk of bias due to small sample size. The overall quality of evidence for each outcome was generally low for reasons including unclear risk of bias in studies, imprecision, and low event numbers.Primary outcomeThree studies (277 participants) produced a number needed to treat for an additional beneficial outcome (NNTB) for at least 50% of maximum pain relief versus placebo of 2.4 (95% confidence interval (CI) 1.9 to 3.1) over four hours (low-quality evidence). Four studies (436 participants) produced an NNTB of 3.8 versus placebo (95% CI 2.9 to 5.9) over six hours (low-quality evidence). No studies provided data for the comparison of intravenous diclofenac with another NSAID over four hours. At six hours there was no difference between intravenous diclofenac and another NSAID (low-quality evidence).Secondary outcomesFor secondary efficacy outcomes, intravenous diclofenac was generally superior to placebo and similar to other NSAIDs.For time to rescue medication, comparison of intravenous diclofenac versus placebo demonstrated a median of 226 minutes for diclofenac versus 80 minutes for placebo (5 studies, 542 participants, low-quality evidence). There were insufficient data for pooled analysis for comparisons of diclofenac with another NSAID (very low-quality evidence).For the number of participants using rescue medication, two studies (235 participants) compared diclofenac with placebo. The number needed to treat to prevent one additional harmful event (NNTp) (here, the need for rescue medication) compared with placebo was 3.0 (2.2 to 4.5, low-quality evidence). The comparison of diclofenac with another NSAID included only one study (98 participants). The NNTp was 4.5 (2.5 to 33) for ketorolac versus diclofenac (very low-quality evidence).The numbers of participants withdrawing were generally low and inconsistently reported (very low-quality evidence). Participant withdrawals were: 6% (8/140) diclofenac versus 5% (7/128) placebo, and 9% (8/87) diclofenac versus 7% (6/82) another NSAID for lack of efficacy; 2% (4/211) diclofenac versus 0% (0/198) placebo, and 3% (4/138) diclofenac versus 2% (2/129) another NSAID due to AEs; and 11% (21/191) diclofenac versus 17% (30/179) placebo, and 18% (21/118) diclofenac versus 15% (17/111) another NSAID for any cause.Overall adverse event rates were similar between intravenous diclofenac and placebo (71% in both groups, 2 studies, 296 participants) and between intravenous diclofenac and another NSAID (55% and 58%, respectively, 2 studies, 265 participants) (low-quality evidence for both comparisons). Serious and specific AEs were rare, preventing meta-analysis.There were sufficient data for a dose-effect analysis for our primary outcome for only one alternative dose, 18.75 mg. Analysis of the highest dose employed in each study demonstrated a relative benefit compared with placebo of 1.9 (1.4 to 2.4), whereas for the group receiving 18.75 mg, the relative benefit versus placebo was 1.6 (1.2 to 2.1, 2 studies). Compared to another NSAID, the high-dose analysis demonstrated a relative benefit of 0.9 (0.8 to 1.1), for the group receiving 18.75 mg, the relative benefit was 0.78 (0.65 to 0.93). For direct comparison of high dose versus 18.75 mg, the proportion of participants with at least 50% pain relief was 66% (90/137) for the high-dose arm versus 57% (77/135) in the low-dose arm. There were insufficient data for subgroup meta-analysis of different diclofenac formulations.The amount and quality of evidence for the use of intravenous diclofenac as a treatment for postoperative pain is low. The available evidence indicates that postoperative intravenous diclofenac administration offers good pain relief for the majority of patients, but further research may impact this estimate. Adverse events appear to occur at a similar rate to other NSAIDs. Insufficient information is available to assess whether intravenous diclofenac has a different rate of bleeding, renal dysfunction, or cardiovascular events versus other NSAIDs. There was insufficient information to evaluate the efficacy and safety of newer versus traditional formulations of intravenous diclofenac. There was a lack of studies in major and cardiovascular surgeries and in elderly populations, which may be at increased risk for adverse events." @default.
• W2779043310 created "2018-01-05" @default.
• W2779043310 creator A5021005997 @default.
• W2779043310 creator A5048354376 @default.
• W2779043310 creator A5090784843 @default.
• W2779043310 date "2018-08-28" @default.
• W2779043310 modified "2023-10-02" @default.
• W2779043310 title "Single-dose intravenous diclofenac for acute postoperative pain in adults" @default.
• W2779043310 cites W1493169611 @default.
• W2779043310 cites W1504991804 @default.
• W2779043310 cites W1535268597 @default.
• W2779043310 cites W1545511753 @default.
• W2779043310 cites W1557057763 @default.
• W2779043310 cites W1563310794 @default.
• W2779043310 cites W1594969061 @default.
• W2779043310 cites W1650178754 @default.
• W2779043310 cites W1673301128 @default.
• W2779043310 cites W178231796 @default.
• W2779043310 cites W1906359819 @default.
• W2779043310 cites W1949453356 @default.
• W2779043310 cites W1966578512 @default.
• W2779043310 cites W1970429791 @default.
• W2779043310 cites W1987834296 @default.
• W2779043310 cites W1988363421 @default.
• W2779043310 cites W1997697804 @default.
• W2779043310 cites W2001162433 @default.
• W2779043310 cites W2003491622 @default.
• W2779043310 cites W2005491182 @default.
• W2779043310 cites W2011914532 @default.
• W2779043310 cites W2012801178 @default.
• W2779043310 cites W2016338678 @default.
• W2779043310 cites W2017448834 @default.
• W2779043310 cites W2019043387 @default.
• W2779043310 cites W2020131209 @default.
• W2779043310 cites W2021047309 @default.
• W2779043310 cites W2032361861 @default.
• W2779043310 cites W2033223166 @default.
• W2779043310 cites W2040489008 @default.
• W2779043310 cites W2040709342 @default.
• W2779043310 cites W2041356923 @default.
• W2779043310 cites W2042532851 @default.
• W2779043310 cites W2045994976 @default.
• W2779043310 cites W2047586716 @default.
• W2779043310 cites W2054366544 @default.
• W2779043310 cites W2064215587 @default.
• W2779043310 cites W2065737200 @default.
• W2779043310 cites W2069068496 @default.
• W2779043310 cites W2070578916 @default.
• W2779043310 cites W2072856001 @default.
• W2779043310 cites W2073000525 @default.
• W2779043310 cites W2083813624 @default.
• W2779043310 cites W2086695113 @default.
• W2779043310 cites W2092233783 @default.
• W2779043310 cites W2093006946 @default.
• W2779043310 cites W2093043874 @default.
• W2779043310 cites W2104770054 @default.
• W2779043310 cites W2107021177 @default.
• W2779043310 cites W2111149452 @default.
• W2779043310 cites W2111347002 @default.
• W2779043310 cites W2112382706 @default.
• W2779043310 cites W2131807935 @default.
• W2779043310 cites W2133347503 @default.
• W2779043310 cites W2135444981 @default.
• W2779043310 cites W2135665676 @default.
• W2779043310 cites W2142346036 @default.
• W2779043310 cites W2144826128 @default.
• W2779043310 cites W2145887563 @default.
• W2779043310 cites W2156098321 @default.
• W2779043310 cites W2161893018 @default.
• W2779043310 cites W2163608309 @default.
• W2779043310 cites W2165963475 @default.
• W2779043310 cites W2166939717 @default.
• W2779043310 cites W2167223967 @default.
• W2779043310 cites W2227291871 @default.
• W2779043310 cites W2234442805 @default.
• W2779043310 cites W2257876134 @default.
• W2779043310 cites W2330681984 @default.
• W2779043310 cites W2336632768 @default.
• W2779043310 cites W2343865036 @default.
• W2779043310 cites W2397436016 @default.
• W2779043310 cites W2399737318 @default.
• W2779043310 cites W2407638182 @default.
• W2779043310 cites W2409622145 @default.
• W2779043310 cites W2412124415 @default.
• W2779043310 cites W2413530320 @default.
• W2779043310 cites W2413984312 @default.
• W2779043310 cites W2415636851 @default.
• W2779043310 cites W2416028957 @default.
• W2779043310 cites W2416465994 @default.
• W2779043310 cites W2418225844 @default.
• W2779043310 cites W246286872 @default.
• W2779043310 cites W2494348136 @default.
• W2779043310 cites W2499465213 @default.
• W2779043310 cites W2522202484 @default.
• W2779043310 cites W2561069061 @default.
• W2779043310 cites W2911681166 @default.
• W2779043310 cites W2993195877 @default.
• W2779043310 cites W4235359097 @default.
• W2779043310 cites W4238092625 @default.
• W2779043310 cites W4241261141 @default.

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