CoChat
Sign Up
Cited by 141Anesthesia and Pain ManagementPain Management and Opioid UseNausea and vomiting management

The DOI matches its Crossref record; 129 of the 129 references it cites were found in a registry or an index.

Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults

Open access
Gaskell, Helen, Derry, Sheena, Moore, R Andrew, McQuay, Henry J·2009·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd002763.pub2PMC PMC4170904
Open this paper in CoChat — free account

Abstract

BACKGROUND: Oxycodone is a strong opioid agonist used to treat severe pain. It is commonly combined with milder analgesics such as paracetamol. This review updates a previous review that concluded, based on limited data, that all doses of oxycodone exceeding 5 mg, with or without paracetamol, provided analgesia in postoperative pain, but with increased incidence of adverse events compared with placebo. Additional new studies provide more reliable estimates of efficacy and harm. OBJECTIVES: To assess efficacy, duration of action, and associated adverse events of single dose oral oxycodone, with or without paracetamol, in acute postoperative pain in adults. SEARCH STRATEGY: Cochrane CENTRAL, MEDLINE, EMBASE and Oxford Pain Relief Database, searched in May 2009. SELECTION CRITERIA: Randomised, double blind, placebo-controlled trials of single dose orally administered oxycodone, with or without paracetamol, in adults with moderate to severe acute postoperative pain. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk and number-needed-to-treat-to-benefit (NNT) were calculated. Numbers of participants remedicating over specified time periods, and time-to-use of rescue medication, were sought as additional measures of efficacy. Adverse events and withdrawals information was collected. MAIN RESULTS: This updated review includes 20 studies, with 2641 participants. For oxycodone 15 mg alone compared with placebo, the NNT for at least 50% pain relief was 4.6 (95% Confidence Interval 2.9 to 11). For oxycodone 10 mg plus paracetamol 650 mg, the NNT was 2.7 (2.4 to 3.1). A dose response was demonstrated for this outcome with combination therapy. Duration of effect was 10 hours with oxycodone 10 mg plus paracetamol 650 mg, and 4 hours with half that dose. Fewer participants needed rescue medication over 6 hours at the higher dose. Adverse events occurred more frequently with combination therapy than placebo, but were generally described as mild to moderate in severity and rarely led to withdrawal. AUTHORS' CONCLUSIONS: Single dose oxycodone is an effective analgesic in acute postoperative pain at doses over 5 mg; oxycodone is two to three times stronger than codeine. Efficacy increases when combined with paracetamol. Oxycodone 10 mg plus paracetamol 650 mg provides good analgesia to half of those treated, comparable to commonly used non-steroidal anti-inflammatory drugs, with the benefit of longer duration of action.

Overview

Integrity signals

Registry

Crossref · 10.1002/14651858.cd002763.pub2

Cites

129 of 129 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 8

  1. Beck, 1923, Uber experiences with Eukodal, Munch Med Wachr, 70, 908
  2. Moore, 1993, Combination low-dose epidural morphine and parenteral ketorolac tromethamine for postcesarean pain relief, The Journal of the American Association of Nurse Anesthetists, 61, 426
  3. Roehrich, 1993, (No title cited), Pharmacy and Therapeutics, 18, 989
  4. Siegied, 1918, The new narcotic Eukodal, Deutsche Medizinische Wochenschrift, 14, 185
  5. Tigerstedt I Tammisto T Leander P Buprenorphine vs. oxycodone as a routine postoperative analgesic Nordic Symposium on Temgesic. A new perspective of pain - Buprenorphone. Proceedings of the Nordic Symposium on Temgesic Copenhagen 1981
  6. Cooper, 1991, Single-dose analgesic studies: the upside and downside of assay sensitivity, 18, 117
  7. Morris, 1995, Calculating confidence intervals for relative risk, odds ratios and standardised ratios and rates, 50
  8. Twycross, 2006, Analgesics, Chapter 5, 226

Cited by

Sorted by citations

See all 141

Related

See all

Metadata

Authors
Gaskell, H., Derry, S., Moore, R. A., & McQuay, H. J.
Affiliations
University of Oxford (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2009-07-08
Volume
2019
Issue
5
Pages
CD002763-CD002763
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd002763.pub2
PMC
PMC4170904
OpenAlex
W2145612300
Cited by
141
References
129
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 12 · 2020: 3 · 2019: 6 · 2018: 10 · 2017: 4 · 2016: 7 · 2015: 15 · 2014: 16 · 2013: 13 · 2012: 10
FWCI
1.60
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Surgery › Nausea and vomiting management
Keywords
oxycodone, paracetamol, acute postoperative pain, opioid combination therapy, analgesia, duration of analgesia, rescue medication, adverse events, opioid withdrawal, dose-response relationship, number needed to treat, adults, placebo comparison, opioid analgesics, nonsteroidal anti-inflammatory drugs
MeSH terms
Acetaminophen, Acute Disease, Adult, Analgesics, Opioid, Drug Synergism, Drug Therapy, Combination, Humans, Oxycodone, Postoperative Pain, Pain, Postoperative, Randomized Controlled Trials as Topic, Analgesics, Non-Narcotic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review