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2016 Study flow diagram.
Figuras y tablas -
Figure 1

2016 Study flow diagram.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Number of participants with > 50% pain relief over 4 hours, outcome: 1.1 Propacetamol or paracetamol versus placebo.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Number of participants with > 50% pain relief over 4 hours, outcome: 1.1 Propacetamol or paracetamol versus placebo.

Forest plot of comparison: 2 Number of participants with > 50% pain relief over 6 hours, outcome: 2.1 Propacetamol or paracetamol versus placebo.
Figuras y tablas -
Figure 5

Forest plot of comparison: 2 Number of participants with > 50% pain relief over 6 hours, outcome: 2.1 Propacetamol or paracetamol versus placebo.

Forest plot of comparison: 15 Pain on infusion, outcome: 15.3 Propacetamol versus paracetamol.
Figuras y tablas -
Figure 6

Forest plot of comparison: 15 Pain on infusion, outcome: 15.3 Propacetamol versus paracetamol.

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 1.1

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 1.2

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 1.3

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 3 Propacetamol vs opioids.

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 4 Paracetamol vs propacetamol.
Figuras y tablas -
Analysis 1.4

Comparison 1 Number of participants with > 50% pain relief over 4 hours, Outcome 4 Paracetamol vs propacetamol.

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 2.1

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 2.2

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 2.3

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 3 Propacetamol vs opioids.

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 4 Paracetamol vs propacetamol.
Figuras y tablas -
Analysis 2.4

Comparison 2 Number of participants with > 50% pain relief over 6 hours, Outcome 4 Paracetamol vs propacetamol.

Comparison 3 Pain intensity at 4 h, Outcome 1 Paracetamol vs placebo.
Figuras y tablas -
Analysis 3.1

Comparison 3 Pain intensity at 4 h, Outcome 1 Paracetamol vs placebo.

Comparison 3 Pain intensity at 4 h, Outcome 2 Paracetamol vs NSAIDs.
Figuras y tablas -
Analysis 3.2

Comparison 3 Pain intensity at 4 h, Outcome 2 Paracetamol vs NSAIDs.

Comparison 3 Pain intensity at 4 h, Outcome 4 Paracetamol vs ketamine.
Figuras y tablas -
Analysis 3.4

Comparison 3 Pain intensity at 4 h, Outcome 4 Paracetamol vs ketamine.

Comparison 4 Pain intensity at 6 h, Outcome 1 Paracetamol vs placebo.
Figuras y tablas -
Analysis 4.1

Comparison 4 Pain intensity at 6 h, Outcome 1 Paracetamol vs placebo.

Comparison 4 Pain intensity at 6 h, Outcome 2 Paracetamol vs NSAIDs.
Figuras y tablas -
Analysis 4.2

Comparison 4 Pain intensity at 6 h, Outcome 2 Paracetamol vs NSAIDs.

Comparison 4 Pain intensity at 6 h, Outcome 3 Paracetamol vs opioids.
Figuras y tablas -
Analysis 4.3

Comparison 4 Pain intensity at 6 h, Outcome 3 Paracetamol vs opioids.

Comparison 4 Pain intensity at 6 h, Outcome 4 Paracetamol vs ketamine.
Figuras y tablas -
Analysis 4.4

Comparison 4 Pain intensity at 6 h, Outcome 4 Paracetamol vs ketamine.

Comparison 5 Number of participants requiring rescue medication, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 5.1

Comparison 5 Number of participants requiring rescue medication, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 5 Number of participants requiring rescue medication, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 5.2

Comparison 5 Number of participants requiring rescue medication, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 5 Number of participants requiring rescue medication, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 5.3

Comparison 5 Number of participants requiring rescue medication, Outcome 3 Propacetamol vs opioids.

Comparison 5 Number of participants requiring rescue medication, Outcome 4 Paracetamol vs propacetamol.
Figuras y tablas -
Analysis 5.4

Comparison 5 Number of participants requiring rescue medication, Outcome 4 Paracetamol vs propacetamol.

Comparison 6 Time to rescue medication (minutes), Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 6.1

Comparison 6 Time to rescue medication (minutes), Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 6 Time to rescue medication (minutes), Outcome 2 Paracetamol vs NSAIDs.
Figuras y tablas -
Analysis 6.2

Comparison 6 Time to rescue medication (minutes), Outcome 2 Paracetamol vs NSAIDs.

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 7.1

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 7.2

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 7.3

Comparison 7 Opioid consumption (IV morphine equivalents) over 4 hours, Outcome 3 Propacetamol vs opioids.

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 8.1

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 8.2

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 8.3

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 3 Propacetamol vs opioids.

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 4 Paracetamol vs propacetamol.
Figuras y tablas -
Analysis 8.4

Comparison 8 Opioid consumption (IV morphine equivalents) over 6 hours, Outcome 4 Paracetamol vs propacetamol.

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 9.1

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 9.2

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 9.3

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 3 Propacetamol vs opioids.

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 4 Paracetamol vs propacetamol.
Figuras y tablas -
Analysis 9.4

Comparison 9 Global evaluation rated as good/satisfied or excellent/very satisfied, Outcome 4 Paracetamol vs propacetamol.

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 10.1

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 2 Paracetamol vs NSAIDs.
Figuras y tablas -
Analysis 10.2

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 2 Paracetamol vs NSAIDs.

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 10.3

Comparison 10 Global evaluation using a numerical rating scale (0 to 10), Outcome 3 Propacetamol vs opioids.

Comparison 11 Number of participants with adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 11.1

Comparison 11 Number of participants with adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 11 Number of participants with adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
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Analysis 11.2

Comparison 11 Number of participants with adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 11 Number of participants with adverse events, Outcome 3 Propacetamol vs opioids.
Figuras y tablas -
Analysis 11.3

Comparison 11 Number of participants with adverse events, Outcome 3 Propacetamol vs opioids.

Comparison 12 Number of participants with serious adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 12.1

Comparison 12 Number of participants with serious adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 12 Number of participants with serious adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 12.2

Comparison 12 Number of participants with serious adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 12 Number of participants with serious adverse events, Outcome 3 Paracetamol or propacetamol vs opioids.
Figuras y tablas -
Analysis 12.3

Comparison 12 Number of participants with serious adverse events, Outcome 3 Paracetamol or propacetamol vs opioids.

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 13.1

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 13.2

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 3 Paracetamol or propacetamol vs opioids.
Figuras y tablas -
Analysis 13.3

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 3 Paracetamol or propacetamol vs opioids.

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 4 Paracetamol vs ketamine.
Figuras y tablas -
Analysis 13.4

Comparison 13 Number of participants withdrawing due to adverse events, Outcome 4 Paracetamol vs ketamine.

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 1 Paracetamol or propacetamol vs placebo.
Figuras y tablas -
Analysis 14.1

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 1 Paracetamol or propacetamol vs placebo.

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 2 Paracetamol or propacetamol vs NSAIDs.
Figuras y tablas -
Analysis 14.2

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 2 Paracetamol or propacetamol vs NSAIDs.

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 3 Paracetamol or propacetamol vs opioids.
Figuras y tablas -
Analysis 14.3

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 3 Paracetamol or propacetamol vs opioids.

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 4 Paracetamol vs ketamine.
Figuras y tablas -
Analysis 14.4

Comparison 14 Number of participants withdrawing due to lack of efficacy, Outcome 4 Paracetamol vs ketamine.

Comparison 15 Number of participants with pain on infusion, Outcome 1 Paracetamol vs placebo.
Figuras y tablas -
Analysis 15.1

Comparison 15 Number of participants with pain on infusion, Outcome 1 Paracetamol vs placebo.

Comparison 15 Number of participants with pain on infusion, Outcome 2 Propacetamol vs placebo.
Figuras y tablas -
Analysis 15.2

Comparison 15 Number of participants with pain on infusion, Outcome 2 Propacetamol vs placebo.

Comparison 15 Number of participants with pain on infusion, Outcome 3 Propacetamol vs paracetamol.
Figuras y tablas -
Analysis 15.3

Comparison 15 Number of participants with pain on infusion, Outcome 3 Propacetamol vs paracetamol.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 1 Nausea.
Figuras y tablas -
Analysis 16.1

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 1 Nausea.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 2 Vomiting.
Figuras y tablas -
Analysis 16.2

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 2 Vomiting.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 3 Nausea/vomiting.
Figuras y tablas -
Analysis 16.3

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 3 Nausea/vomiting.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 4 Pruritus.
Figuras y tablas -
Analysis 16.4

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 4 Pruritus.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 5 Respiratory depression.
Figuras y tablas -
Analysis 16.5

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 5 Respiratory depression.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 6 Sedation.
Figuras y tablas -
Analysis 16.6

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 6 Sedation.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 7 Urinary retention.
Figuras y tablas -
Analysis 16.7

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 7 Urinary retention.

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 8 Allergy/skin rash/local reaction.
Figuras y tablas -
Analysis 16.8

Comparison 16 Individual adverse events: paracetamol or propacetamol vs placebo, Outcome 8 Allergy/skin rash/local reaction.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 1 Nausea.
Figuras y tablas -
Analysis 17.1

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 1 Nausea.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 2 Vomiting.
Figuras y tablas -
Analysis 17.2

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 2 Vomiting.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 3 Nausea/vomiting.
Figuras y tablas -
Analysis 17.3

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 3 Nausea/vomiting.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 4 Pruritus.
Figuras y tablas -
Analysis 17.4

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 4 Pruritus.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 5 Respiratory depression.
Figuras y tablas -
Analysis 17.5

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 5 Respiratory depression.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 6 Sedation.
Figuras y tablas -
Analysis 17.6

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 6 Sedation.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 7 Urinary retention.
Figuras y tablas -
Analysis 17.7

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 7 Urinary retention.

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 8 Allergy/skin rash/local reaction.
Figuras y tablas -
Analysis 17.8

Comparison 17 Individual adverse events: paracetamol or propacetamol vs NSAIDs, Outcome 8 Allergy/skin rash/local reaction.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 1 Nausea.
Figuras y tablas -
Analysis 18.1

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 1 Nausea.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 2 Vomiting.
Figuras y tablas -
Analysis 18.2

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 2 Vomiting.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 3 Nausea/vomiting.
Figuras y tablas -
Analysis 18.3

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 3 Nausea/vomiting.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 4 Pruritus.
Figuras y tablas -
Analysis 18.4

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 4 Pruritus.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 5 Respiratory depression.
Figuras y tablas -
Analysis 18.5

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 5 Respiratory depression.

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 6 Sedation.
Figuras y tablas -
Analysis 18.6

Comparison 18 Individual adverse events: paracetamol or propacetamol vs opioids, Outcome 6 Sedation.

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 1 Nausea.
Figuras y tablas -
Analysis 19.1

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 1 Nausea.

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 2 Vomiting.
Figuras y tablas -
Analysis 19.2

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 2 Vomiting.

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 3 Sedation.
Figuras y tablas -
Analysis 19.3

Comparison 19 Individual adverse events: paracetamol vs ketamine, Outcome 3 Sedation.

Summary of findings for the main comparison. Proportion of participants experiencing at least 50% of maximum pain relief at 4 hours

IV paracetamol/propacetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol/propacetamol
Comparison: placebo or other analgesics

Comparison

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk

Placebo or other analgesics

IV paracetamol/propacetamol

Para/propacetamol vs placebo
see footnote1

156 per 1000

394 per 1000
(313 to 497)

RR 2.53
(2.01 to 3.19)

1149
(11 studies)

⊕⊕⊕⊕
high2,3

Paracetamol vs placebo
see footnote1

66 per 1000

317 per 1000
(152 to 661)

RR 4.8
(2.3 to 10)

393
(5 studies)

⊕⊕⊕⊝
moderate2,3,4

Propacetamol vs placebo
see footnote1

188 per 1000

411 per 1000
(327 to 520)

RR 2.19
(1.74 to 2.77)

756
(8 studies)

⊕⊕⊕⊝
moderate2,3,4

Para/propacetamol vs NSAIDs
see footnote1

599 per 1000

605 per 1000
(515 to 707)

RR 1.01
(0.86 to 1.18)

353
(5 studies)

⊕⊕⊝⊝
low4,5

Paracetamol vs NSAIDs
see footnote1

631 per 1000

568 per 1000
(454 to 713)

RR 0.9
(0.72 to 1.13)

130
(2 studies)

⊕⊝⊝⊝
very low4,5,6

Propacetamol vs NSAIDs
see footnote1

577 per 1000

624 per 1000
(496 to 774)

RR 1.08
(0.86 to 1.34)

223
(3 studies)

⊕⊝⊝⊝
very low2,4,5,6

Paracetamol vs propacetamol
see footnote1

428 per 1000

419 per 1000
(329 to 530)

RR 0.98
(0.77 to 1.24)

361
(3 studies)

⊕⊕⊕⊝
moderate4

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; IV: intravenous; NSAIDs: nonsteroidal anti‐inflammatory drugs; RR: risk ratio; SPID = summed pain intensity difference; TOTPAR = total pain relief; VAS: visual analog scale

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1TOTPAR or SPID using either VAS or categorical data, and calculating their corresponding percentage of theoretical maximum TOTPAR and SPID.
2Considerable unexplained heterogeneity exists between studies.
3Large effect.
4Total # events < 300.
5Different NSAIDs studied.
6Wide confidence interval that includes no effect and appreciable benefit and/or harm.

Figuras y tablas -
Summary of findings for the main comparison. Proportion of participants experiencing at least 50% of maximum pain relief at 4 hours
Summary of findings 2. Proportion of participants experiencing at least 50% of maximum pain relief at 6 hours

IV paracetamol/propacetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol/propacetamol
Comparison: placebo or other analgesics

Comparison

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk

Placebo or other analgesics

IV paracetamol/propacetamol

Para/propacetamol vs placebo
see footnote1

97 per 1000

276 per 1000
(203 to 378)

RR 2.86
(2.1 to 3.91)

1143
(10 studies)

⊕⊕⊕⊝
moderate2,3,4

Paracetamol vs placebo
see footnote1

83 per 1000

304 per 1000
(179 to 517)

RR 3.65
(2.15 to 6.21)

532
(6 studies)

⊕⊕⊕⊝
moderate2,3,4

Propacetamol vs placebo
see footnote1

105 per 1000

252 per 1000
(172 to 367)

RR 2.4
(1.64 to 3.5)

611
(6 studies)

⊕⊕⊝⊝
low2,3,4,5,6

Para/propacetamol vs NSAIDs
see footnote1

632 per 1000

499 per 1000
(417 to 600)

RR 0.79
(0.66 to 0.95)

355
(5 studies)

⊕⊝⊝⊝
very low3,7,8

Paracetamol vs NSAIDs
see footnote1

623 per 1000

511 per 1000
(411 to 635)

RR 0.82
(0.66 to 1.02)

212
(3 studies)

⊕⊝⊝⊝
very low3,7,9,10

Propacetamol vs NSAIDs
see footnote1

649 per 1000

487 per 1000
(364 to 662)

RR 0.75
(0.56 to 1.02)

143
(2 studies)

⊕⊝⊝⊝
very low3,7,9,10

Paracetamol vs propacetamol
see footnote1

411 per 1000

386 per 1000
(300 to 493)

RR 0.94
(0.73 to 1.2)

361
(3 studies)

⊕⊕⊝⊝
low3,10

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NNT = number needed to treat to benefit; NSAIDs: nonsteroidal anti‐inflammatory drugs; RR: risk ratio; SPID = summed pain intensity difference; TOTPAR = total pain relief; VAS: visual analog scale

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1TOTPAR or SPID using either VAS or categorical data, and calculating their corresponding percentage of theoretical maximum TOTPAR and SPID.
2Considerable unexplained heterogeneity exists between studies.
3Total # events <300.
4Large effect.
5One study data "not estimable" because of zero events in both groups.
6Publication bias favoring propacetamol; < 400 additional participants needed in studies with zero effect (relative benefit of one) required to change the NNT for at least 50% maximum pain relief to an unacceptably high level (in this case a NNT of 10).
7Different NSAIDs studied.
8Publication bias for superiority of NSAID; < 400 additional participants needed in studies with zero effect (relative benefit of one) required to change the NNT for at least 50% maximum pain relief to an unacceptably high level (in this case a NNT of 10).
9All individual studies < 100 participants.
10Wide confidence interval that includes no effect and appreciable benefit and/or harm.

Figuras y tablas -
Summary of findings 2. Proportion of participants experiencing at least 50% of maximum pain relief at 6 hours
Summary of findings 3. Mean pain intensity over a 4‐hour period

IV paracetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol
Comparison: placebo or other analgesics

Comparison

Illustrative comparative risks* (95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Paracetamol vs placebo

The mean pain intensity over a 4‐hour period was:
1.21 lower (3.73 lower to 1.31 higher)

485
(6 studies)

⊕⊕⊝⊝
low1,2

Paracetamol vs NSAIDs

The mean pain intensity over a 4‐hour period was:
5.02 higher (3.18 to 6.86 higher)

350
(6 studies)

⊕⊝⊝⊝
very low1,3,4,5,6

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NSAIDs: nonsteroidal anti‐inflammatory drugs

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1See 'Risk of bias' tables; several unclear assessments related to randomization; unclear to high risk for selective reporting.
2Wide confidence interval that includes no effect and appreciable benefit and/or harm.
3Total population size < 400.
4Majority of all individual studies had < 100 total participants.
5Considerable unexplained heterogeneity exists between studies.
6Different NSAIDs studied.

Figuras y tablas -
Summary of findings 3. Mean pain intensity over a 4‐hour period
Summary of findings 4. Mean pain intensity over a 6‐hour period

IV paracetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol
Comparison: placebo or other analgesics

Outcomes

Illustrative comparative risks* (95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Paracetamol vs placebo

The mean pain intensity over a 6‐hour period was:
7.48 lower (8.98 to 5.97 lower)

837
(12 studies)

⊕⊕⊝⊝
low1,2

Paracetamol vs NSAIDs

The mean pain intensity over a 6‐hour period was:
2.95 higher (1.18 to 4.72 higher)

524
(9 studies)

⊕⊝⊝⊝
very low2,3,4

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NSAIDs: nonsteroidal anti‐inflammatory drugs

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Majority of all individual studies had < 100 total participants.
2Considerable unexplained heterogeneity exists between studies.
3See 'Risk of bias' tables: several unclear assessments related to randomization; unclear to high risk for selective reporting.
4Different NSAIDs studied.

Figuras y tablas -
Summary of findings 4. Mean pain intensity over a 6‐hour period
Summary of findings 5. Proportion of participants receiving additional analgesic medication

IV paracetamol/propacetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol/propacetamol
Comparison: placebo or other analgesics

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk

Placebo or other analgesics

IV paracetamol/propacetamol

Para/propacetamol vs placebo

820 per 1000

574 per 1000
(525 to 631)

RR 0.7
(0.64 to 0.77)

859
(9 studies)

⊕⊕⊝⊝
low1,2

Paracetamol vs placebo

892 per 1000

669 per 1000
(616 to 732)

RR 0.75
(0.69 to 0.82)

655
(6 studies)

⊕⊕⊝⊝
low1,2

Propacetamol vs placebo

625 per 1000

306 per 1000
(219 to 431)

RR 0.49
(0.35 to 0.69)

204
(3 studies)

⊕⊕⊝⊝
low1,2,3,4,5

Para/propacetamol vs NSAIDs

284 per 1000

338 per 1000
(247 to 463)

RR 1.19
(0.87 to 1.63)

309
(5 studies)

⊕⊝⊝⊝
very low1,3,4,6,7

Paracetamol vs NSAIDs

200 per 1000

216 per 1000
(118 to 396)

RR 1.08
(0.59 to 1.98)

120
(2 studies)

⊕⊝⊝⊝
very low1,3,4,6,7

Propacetamol vs NSAIDs

337 per 1000

414 per 1000
(290 to 596)

RR 1.23
(0.86 to 1.77)

189
(3 studies)

⊕⊝⊝⊝
very low1,3,4,6,7

Propacetamol vs opioids

86 per 1000

157 per 1000
(62 to 398)

RR 1.83
(0.72 to 4.64)

139
(2 studies)

⊕⊝⊝⊝
very low1,3,4,7

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NSAIDs: nonsteroidal anti‐inflammatory drugs; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1See 'Risk of bias' tables: several unclear assessments related to randomization and attrition bias; unclear to high risk for selective outcome reporting.
2Considerable unexplained heterogeneity exists between studies.
3Majority of all individual studies had < 100 total participants.
4Total # events < 300.
5Large effect.
6Different NSAIDs studied.
7Wide confidence interval that includes no effect and appreciable benefit and/or harm.

Figuras y tablas -
Summary of findings 5. Proportion of participants receiving additional analgesic medication
Summary of findings 6. Opioid consumption (IV morphine equivalents) over 6 hours

IV paracetamol/propacetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol/propacetamol
Comparison: placebo or other analgesics

Outcomes

Illustrative comparative risks* (95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Para/propacetamol vs placebo
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
1.92 lower (2.41 to 1.42 lower)

777
(13 studies)

⊕⊕⊕⊝
moderate2,3

Paracetamol vs placebo
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
1.83 lower (2.35 to 1.31 lower)

404
(8 studies)

⊕⊕⊝⊝
low2,3,4

Propacetamol vs placebo
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
2.67 lower (4.21 to 1.13 lower)

373
(6 studies)

⊕⊕⊝⊝
low2,4,5

Para/propacetamol vs NSAIDs
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
0.12 lower (0.37 lower to 0.12 higher)

540
(8 studies)

⊕⊝⊝⊝
very low2,3,6

Paracetamol vs NSAIDs
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
0.81 higher (0.87 lower to 2.49 higher)

160
(3 studies)

⊕⊝⊝⊝
very low3,5,6,7

Propacetamol vs NSAIDs
see footnote1

The mean opioid consumption (IV morphine equivalents) over 6 hours was:
0.14 lower (0.39 lower to 0.11 higher)

380
(5 studies)

⊕⊝⊝⊝
very low5,6,7

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NSAIDs: nonsteroidal anti‐inflammatory drugs

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Mean opioid consumption (in mg) over 6 hours in each treatment arm converted into IV morphine‐equivalents, using commonly used and widely accepted opioid conversion tables.
2See 'Risk of bias' tables: several unclear assessments related to randomization, unclear risk for selective reporting.
3Majority of all individual studies had < 100 participants.
4Considerable unexplained heterogeneity exists between studies.
5Total population size < 400.
6Different NSAIDs studied.
7Wide confidence interval that includes no effect and appreciable benefit and/or harm.

Figuras y tablas -
Summary of findings 6. Opioid consumption (IV morphine equivalents) over 6 hours
Summary of findings 7. Proportion of participants vomiting

IV paracetamol/propacetamol compared to placebo or other analgesics for postoperative pain

Patient or population: patients with postoperative pain
Settings: hospital
Intervention: IV paracetamol/propacetamol
Comparison: placebo or other analgesics

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk

Placebo or other analgesics

IV paracetamol/propacetamol

Para/propacetamol vs placebo

208 per 1000

145 per 1000
(118 to 181)

RR 0.7
(0.57 to 0.87)

1414
(15 studies)

⊕⊝⊝⊝
very low1,2,3,4

Paracetamol vs placebo

263 per 1000

168 per 1000
(134 to 210)

RR 0.64
(0.51 to 0.8)

1037
(13 studies)

⊕⊝⊝⊝
very low1,3,4

Propacetamol vs placebo

45 per 1000

74 per 1000
(34 to 158)

RR 1.62
(0.75 to 3.48)

377
(3 studies)

⊕⊕⊝⊝
low3,5

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; NNH = number needed to treat to harm; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Majority of all individual studies had < 100 participants.
2Considerable unexplained heterogeneity exists between studies.
3Total # events < 300.
4Publication bias suspected in favor of a lower occurrence of vomiting in the paracetamol and/or propacetamol arm; NNH > 10.
5Wide confidence interval that includes no effect and appreciable benefit and/or harm.

Figuras y tablas -
Summary of findings 7. Proportion of participants vomiting
Table 1. Publication bias risk assessment: efficacy outcomes

Comparison/outcome

Number of studies

Number of participants

n with outcome/total

% with outcome

Risk difference

NNT

Susceptibility to publication bias

Active

Control

Active

Control

Comparison 1. Number of participants with > 50% pain relief over 4 hours

1 Paracetamol or propacetamol vs placebo

11

1149

250/687

72/462

36

16

0.23 (0.18 to 0.27)

5

1492

1.1 Paracetamol vs placebo

5

393

84/272

8/121

31

7

0.24 (0.17 to 0.31)

5

549

1.2 Propacetamol vs placebo

8

756

166/415

64/341

40

19

0.22 (0.17 to 0.27)

5

906

Comparison 2. Number of participants with > 50% pain relief over 6 hours

1 Paracetamol or propacetamol vs placebo

10

1143

200/708

42/435

28

10

0.18 (0.14 to 0.22)

6

913

1.1 Paracetamol vs placebo

6

532

109/364

14/168

30

8

0.22 (0.16 to 0.29)

5

637

1.2 Propacetamol vs placebo

6

611

91/344

28/267

26

10

0.15 (0.10 0.20)

7

305

2. Paracetamol or propacetamol vs NSAIDs

5

355

95/192

103/163

50

63

‐0.13 (‐0.23 to ‐0.03)

8*

107

Comparison 5. Number of participants requiring rescue medication

1 Paracetamol or propacetamol vs placebo

9

859

295/476

314/383

62

82

‐0.25 (‐0.30 to ‐0.19)

4

1289

1.1 Paracetamol vs placebo

6

655

267/376

249/279

71

89

‐0.22 (‐0.28 to ‐0.17)

5

785

1.2 Propacetamol vs placebo

3

204

31/100

65/104

31

62

‐0.32 (‐0.44 to ‐0.19)

4

449

Comparison 9. Global evaluation rated as good/satisfied or excellent/very satisfied

1 Paracetamol or propacetamol vs placebo

16

2015

787/1100

529/915

72

58

0.19 (0.15 to 0.23)

6

1816

1.1 Paracetamol vs placebo

9

876

355/508

207/368

70

56

0.24 (0.19 to 0.29)

5

1225

1.2 Propacetamol vs placebo

9

1139

432/592

322/547

73

59

0.15 (0.10 to 0.21)

7

569

2. Paracetamol or propacetamol vs NSAIDs

11

795

306/410

313/385

75

81

‐0.06 (‐0.11 to ‐4.81)

17*

NNT > 10

*NSAID superior

Figuras y tablas -
Table 1. Publication bias risk assessment: efficacy outcomes
Table 2. Publication bias risk assessment: safety outcomes

Comparison/outcome

Number of studies

Number of participants

n with outcome/total

% with outcome

Risk difference

NNH

Susceptibility to publication bias

Active

Control

Active

Control

Comparison 11. Number of participants with adverse events

1 Paracetamol or propacetamol vs placebo

20

2359

557/1278

400/1081

44

37

0.04 (0.01 to 0.08)

25

NNH > 10

1.2 Propacetamol vs placebo

10

1409

278/740

197/669

38

29

0.05 (0.01 to 0.10)

20

NNH > 10

Comparison 14. Number of participants withdrawing due to lack of efficacy

1.2 Propacetamol vs placebo

14

889

25/477

47/412

5

11

‐0.05 (‐0.08 to ‐0.02)

20*

NNH > 10

Comparison 15. Number of participants with pain on infusion

2. Propacetamol vs placebo

6

645

75/333

4/312

23

1

0.20 (0.16 to 0.24)

5

645

3. Propacetamol vs paracetamol

3

362

71/182

8/180

39

4

0.35 (0.27 to 0.42)

3

904

Comparison 16. Individual adverse events: paracetamol or propacetamol vs placebo

1. Nausea: Paracetamol or propacetamol vs placebo

15

1267

189/660

213/607

29

35

‐0.05 (‐0.10 to ‐0.01)

20*

NNH > 10

1.1. Nausea: Paracetamol vs placebo

13

1037

153/520

196/517

29

38

‐0.09 (‐0.14 to ‐0.04)

11*

NNH > 10

2. Vomiting: Paracetamol or propacetamol vs placebo

15

1414

103/721

144/693

14

21

‐0.06 (‐0.10 to ‐0.03)

17*

NNH > 10

2.1. Vomiting: Paracetamol vs placebo

13

1037

88/520

136/517

17

26

‐0.10 (‐0.14 to ‐0.05)

10*

NNH > 10

Comparison 18. Individual adverse events: paracetamol or propacetamol vs opioids

1. Nausea: Paracetamol or propacetamol vs opioids

6

545

19/272

48/273

7

18

‐0.11 (‐0.16 to ‐0.05)

10*

55

1.1 Nausea: Paracetamol vs opioids

4

438

12/219

39/219

5

18

‐0.12 (‐0.18 to ‐0.07)

9*

88

2. Vomiting: Paracetamol or propacetamol vs opioids

5

495

6/247

20/248

2

8

‐0.06 (‐0.09 to ‐0.02)

17*

NNH > 10

2.1. Vomiting: Paracetamol vs opioids

3

388

4/194

16/194

2

8

‐0.06 (‐0.10 to ‐0.02)

17*

NNH > 10

6.1. Sedation: Paracetamol vs opioids

3

354

2/176

26/178

1

15

‐0.14 (‐0.18 to ‐0.09)

8*

142

*lower occurrence of adverse event in paracetamol and/or propacetamol arm

Figuras y tablas -
Table 2. Publication bias risk assessment: safety outcomes
Comparison 1. Number of participants with > 50% pain relief over 4 hours

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

11

1149

Risk Ratio (M‐H, Fixed, 95% CI)

2.53 [2.01, 3.19]

1.1 Paracetamol vs placebo

5

393

Risk Ratio (M‐H, Fixed, 95% CI)

4.80 [2.30, 10.00]

1.2 Propacetamol vs placebo

8

756

Risk Ratio (M‐H, Fixed, 95% CI)

2.19 [1.74, 2.77]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

5

353

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.86, 1.18]

2.1 Paracetamol vs NSAIDs

2

130

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.72, 1.13]

2.2 Propacetamol vs NSAIDs

3

223

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.86, 1.34]

3 Propacetamol vs opioids Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.85, 1.59]

4 Paracetamol vs propacetamol Show forest plot

3

361

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.77, 1.24]

Figuras y tablas -
Comparison 1. Number of participants with > 50% pain relief over 4 hours
Comparison 2. Number of participants with > 50% pain relief over 6 hours

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

10

1143

Risk Ratio (M‐H, Fixed, 95% CI)

2.86 [2.10, 3.91]

1.1 Paracetamol vs placebo

6

532

Risk Ratio (M‐H, Fixed, 95% CI)

3.65 [2.15, 6.21]

1.2 Propacetamol vs placebo

6

611

Risk Ratio (M‐H, Fixed, 95% CI)

2.40 [1.64, 3.50]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

5

355

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.66, 0.95]

2.1 Paracetamol vs NSAIDs

3

212

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.66, 1.02]

2.2 Propacetamol vs NSAIDs

2

143

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.56, 1.02]

3 Propacetamol vs opioids Show forest plot

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.83, 1.09]

4 Paracetamol vs propacetamol Show forest plot

3

361

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.73, 1.20]

Figuras y tablas -
Comparison 2. Number of participants with > 50% pain relief over 6 hours
Comparison 3. Pain intensity at 4 h

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol vs placebo Show forest plot

6

485

Mean Difference (IV, Fixed, 95% CI)

‐1.21 [‐3.73, 1.31]

2 Paracetamol vs NSAIDs Show forest plot

6

350

Mean Difference (IV, Fixed, 95% CI)

5.02 [3.18, 6.86]

3 Paracetamol vs opioids

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Paracetamol vs ketamine Show forest plot

1

80

Mean Difference (IV, Fixed, 95% CI)

‐12.0 [‐19.23, ‐4.77]

Figuras y tablas -
Comparison 3. Pain intensity at 4 h
Comparison 4. Pain intensity at 6 h

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol vs placebo Show forest plot

12

837

Mean Difference (IV, Fixed, 95% CI)

‐7.48 [‐8.98, ‐5.97]

2 Paracetamol vs NSAIDs Show forest plot

9

524

Mean Difference (IV, Fixed, 95% CI)

2.95 [1.18, 4.72]

3 Paracetamol vs opioids Show forest plot

1

50

Mean Difference (IV, Fixed, 95% CI)

3.0 [‐1.57, 7.57]

4 Paracetamol vs ketamine Show forest plot

1

80

Mean Difference (IV, Fixed, 95% CI)

‐13.0 [‐18.28, ‐7.72]

Figuras y tablas -
Comparison 4. Pain intensity at 6 h
Comparison 5. Number of participants requiring rescue medication

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

9

859

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.64, 0.77]

1.1 Paracetamol vs placebo

6

655

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.69, 0.82]

1.2 Propacetamol vs placebo

3

204

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.35, 0.69]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

5

309

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.87, 1.63]

2.1 Paracetamol vs NSAIDs

2

120

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.59, 1.98]

2.2 Propacetamol vs NSAIDs

3

189

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [0.86, 1.77]

3 Propacetamol vs opioids Show forest plot

2

139

Risk Ratio (M‐H, Fixed, 95% CI)

1.83 [0.72, 4.64]

4 Paracetamol vs propacetamol Show forest plot

1

161

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [0.82, 2.17]

Figuras y tablas -
Comparison 5. Number of participants requiring rescue medication
Comparison 6. Time to rescue medication (minutes)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

9

839

Mean Difference (IV, Fixed, 95% CI)

6.43 [4.54, 8.32]

1.1 Paracetamol vs placebo

6

523

Mean Difference (IV, Fixed, 95% CI)

5.78 [3.86, 7.71]

1.2 Propacetamol vs placebo

3

316

Mean Difference (IV, Fixed, 95% CI)

23.72 [13.79, 33.65]

2 Paracetamol vs NSAIDs Show forest plot

2

138

Mean Difference (IV, Fixed, 95% CI)

‐1.14 [‐36.21, 33.92]

Figuras y tablas -
Comparison 6. Time to rescue medication (minutes)
Comparison 7. Opioid consumption (IV morphine equivalents) over 4 hours

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

6

255

Mean Difference (IV, Fixed, 95% CI)

‐1.42 [‐1.81, ‐1.03]

1.1 Paracetamol vs placebo

4

141

Mean Difference (IV, Fixed, 95% CI)

‐1.33 [‐1.75, ‐0.91]

1.2 Propacetamol vs placebo

2

114

Mean Difference (IV, Fixed, 95% CI)

‐2.05 [‐3.15, ‐0.95]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

3

294

Mean Difference (IV, Fixed, 95% CI)

‐0.19 [‐0.37, ‐0.02]

2.1 Paracetamol vs NSAIDs

2

118

Mean Difference (IV, Fixed, 95% CI)

0.28 [‐1.04, 1.59]

2.2 Propacetamol vs NSAIDs

1

176

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐0.38, ‐0.02]

3 Propacetamol vs opioids Show forest plot

1

80

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐3.09, 1.09]

Figuras y tablas -
Comparison 7. Opioid consumption (IV morphine equivalents) over 4 hours
Comparison 8. Opioid consumption (IV morphine equivalents) over 6 hours

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

13

777

Mean Difference (IV, Fixed, 95% CI)

‐1.92 [‐2.41, ‐1.42]

1.1 Paracetamol vs placebo

8

404

Mean Difference (IV, Fixed, 95% CI)

‐1.83 [‐2.35, ‐1.31]

1.2 Propacetamol vs placebo

6

373

Mean Difference (IV, Fixed, 95% CI)

‐2.67 [‐4.21, ‐1.13]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

8

540

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.37, 0.12]

2.1 Paracetamol vs NSAIDs

3

160

Mean Difference (IV, Fixed, 95% CI)

0.81 [‐0.87, 2.49]

2.2 Propacetamol vs NSAIDs

5

380

Mean Difference (IV, Fixed, 95% CI)

‐0.14 [‐0.39, 0.11]

3 Propacetamol vs opioids Show forest plot

1

80

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐3.01, 2.01]

4 Paracetamol vs propacetamol Show forest plot

1

98

Mean Difference (IV, Fixed, 95% CI)

‐0.40 [‐4.15, 3.35]

Figuras y tablas -
Comparison 8. Opioid consumption (IV morphine equivalents) over 6 hours
Comparison 9. Global evaluation rated as good/satisfied or excellent/very satisfied

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

16

2015

Risk Ratio (M‐H, Fixed, 95% CI)

1.34 [1.25, 1.43]

1.1 Paracetamol vs placebo

9

876

Risk Ratio (M‐H, Fixed, 95% CI)

1.45 [1.31, 1.60]

1.2 Propacetamol vs placebo

9

1139

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [1.16, 1.37]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

11

795

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.87, 1.00]

2.1 Paracetamol vs NSAIDs

6

247

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.91, 1.04]

2.2 Propacetamol vs NSAIDs

5

548

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.82, 1.01]

3 Propacetamol vs opioids Show forest plot

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.81, 1.23]

3.1 Propacetamol

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.81, 1.23]

4 Paracetamol vs propacetamol Show forest plot

2

263

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.83, 1.15]

Figuras y tablas -
Comparison 9. Global evaluation rated as good/satisfied or excellent/very satisfied
Comparison 10. Global evaluation using a numerical rating scale (0 to 10)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

3

342

Mean Difference (IV, Fixed, 95% CI)

0.35 [0.04, 0.66]

1.1 Paracetamol vs placebo

1

60

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.46, 0.26]

1.2 Propacetamol vs placebo

2

282

Mean Difference (IV, Fixed, 95% CI)

1.64 [1.04, 2.25]

2 Paracetamol vs NSAIDs Show forest plot

1

60

Mean Difference (IV, Fixed, 95% CI)

‐0.30 [‐0.63, 0.03]

3 Propacetamol vs opioids Show forest plot

2

141

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐0.18, 0.98]

Figuras y tablas -
Comparison 10. Global evaluation using a numerical rating scale (0 to 10)
Comparison 11. Number of participants with adverse events

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

20

2359

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [1.01, 1.22]

1.1 Paracetamol vs placebo

12

950

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.93, 1.19]

1.2 Propacetamol vs placebo

10

1409

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [1.02, 1.35]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

6

471

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.72, 1.32]

2.1 Paracetamol vs NSAIDs

3

248

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.66, 1.68]

2.2 Propacetamol vs NSAIDs

3

223

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.62, 1.37]

3 Propacetamol vs opioids Show forest plot

1

61

Risk Ratio (M‐H, Fixed, 95% CI)

0.60 [0.29, 1.23]

Figuras y tablas -
Comparison 11. Number of participants with adverse events
Comparison 12. Number of participants with serious adverse events

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

10

970

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.19, 6.59]

1.1 Paracetamol vs placebo

6

634

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.19, 6.59]

1.2 Propacetamol vs placebo

5

336

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

9

798

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.11, 1.65]

2.1 Paracetamol vs NSAIDs

4

270

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.07, 15.26]

2.2 Propacetamol vs NSAIDs

5

528

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.07, 1.65]

3 Paracetamol or propacetamol vs opioids Show forest plot

3

191

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.13, 71.51]

3.1 Paracetamol vs opioids

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 Propacetamol vs opioids

2

141

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.13, 71.51]

Figuras y tablas -
Comparison 12. Number of participants with serious adverse events
Comparison 13. Number of participants withdrawing due to adverse events

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

37

2654

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [0.56, 2.84]

1.1 Paracetamol vs placebo

27

1912

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [0.49, 3.17]

1.2 Propacetamol vs placebo

12

742

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [0.25, 6.68]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

24

1429

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.42, 3.12]

2.1 Paracetamol vs NSAIDs

19

1029

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.31, 3.22]

2.2 Propacetamol vs NSAIDs

5

400

Risk Ratio (M‐H, Fixed, 95% CI)

1.67 [0.22, 12.37]

3 Paracetamol or propacetamol vs opioids Show forest plot

6

505

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.95]

3.1 Paracetamol vs opioids

2

254

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 Propacetamol vs opioids

4

251

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.95]

4 Paracetamol vs ketamine Show forest plot

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 13. Number of participants withdrawing due to adverse events
Comparison 14. Number of participants withdrawing due to lack of efficacy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol or propacetamol vs placebo Show forest plot

38

2600

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.38, 0.79]

1.1 Paracetamol vs placebo

26

1711

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.10, 2.78]

1.2 Propacetamol vs placebo

14

889

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.38, 0.80]

2 Paracetamol or propacetamol vs NSAIDs Show forest plot

24

1393

Risk Ratio (M‐H, Fixed, 95% CI)

1.30 [0.81, 2.08]

2.1 Paracetamol vs NSAIDs

18

934

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.13, 71.89]

2.2 Propacetamol vs NSAIDs

6

459

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [0.78, 2.03]

3 Paracetamol or propacetamol vs opioids Show forest plot

6

505

Risk Ratio (M‐H, Fixed, 95% CI)

5.0 [0.25, 100.97]

3.1 Paracetamol vs opioids

2

254

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 Propacetamol vs opioids

4

251

Risk Ratio (M‐H, Fixed, 95% CI)

5.0 [0.25, 100.97]

4 Paracetamol vs ketamine Show forest plot

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 14. Number of participants withdrawing due to lack of efficacy
Comparison 15. Number of participants with pain on infusion

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Paracetamol vs placebo Show forest plot

3

467

Risk Ratio (M‐H, Fixed, 95% CI)

3.05 [0.80, 11.54]

2 Propacetamol vs placebo Show forest plot

6

645

Risk Ratio (M‐H, Fixed, 95% CI)

13.07 [5.35, 31.98]

3 Propacetamol vs paracetamol Show forest plot

3

362

Risk Ratio (M‐H, Fixed, 95% CI)

8.31 [4.20, 16.46]

Figuras y tablas -
Comparison 15. Number of participants with pain on infusion
Comparison 16. Individual adverse events: paracetamol or propacetamol vs placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Nausea Show forest plot

15

1267

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.73, 0.98]

1.1 Paracetamol vs placebo

13

1037

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.66, 0.90]

1.2 Propacetamol vs placebo

3

230

Risk Ratio (M‐H, Fixed, 95% CI)

1.62 [0.98, 2.69]

2 Vomiting Show forest plot

15

1414

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.57, 0.87]

2.1 Paracetamol vs placebo

13

1037

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.51, 0.80]

2.2 Propacetamol vs placebo

3

377

Risk Ratio (M‐H, Fixed, 95% CI)

1.62 [0.75, 3.48]

3 Nausea/vomiting Show forest plot

10

1064

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.74, 1.08]

3.1 Paracetamol vs placebo

4

191

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.57, 1.70]

3.2 Propacetamol vs placebo

6

873

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.72, 1.08]

4 Pruritus Show forest plot

7

618

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.60, 1.40]

4.1 Paracetamol vs placebo

5

320

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.64, 1.72]

4.2 Propacetamol vs placebo

3

298

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.29, 1.51]

5 Respiratory depression Show forest plot

11

1082

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.31, 1.92]

5.1 Paracetamol vs placebo

6

363

Risk Ratio (M‐H, Fixed, 95% CI)

0.28 [0.03, 2.65]

5.2 Propacetamol vs placebo

5

719

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.35, 2.80]

6 Sedation Show forest plot

10

566

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.66, 1.51]

6.1 Paracetamol vs placebo

6

341

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.42, 2.01]

6.2 Propacetamol vs placebo

4

225

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.65, 1.69]

7 Urinary retention Show forest plot

8

1050

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.68, 1.66]

7.1 Paracetamol vs placebo

5

373

Risk Ratio (M‐H, Fixed, 95% CI)

1.36 [0.28, 6.66]

7.2 Propacetamol vs placebo

3

677

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.65, 1.66]

8 Allergy/skin rash/local reaction Show forest plot

7

1131

Risk Ratio (M‐H, Fixed, 95% CI)

1.54 [0.61, 3.91]

8.1 Paracetamol vs placebo

4

370

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.24, 4.34]

8.2 Propacetamol vs placebo

4

761

Risk Ratio (M‐H, Fixed, 95% CI)

1.97 [0.57, 6.73]

Figuras y tablas -
Comparison 16. Individual adverse events: paracetamol or propacetamol vs placebo
Comparison 17. Individual adverse events: paracetamol or propacetamol vs NSAIDs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Nausea Show forest plot

11

856

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.90, 1.28]

1.1 Paracetamol vs NSAIDs

8

424

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.74, 1.31]

1.2 Propacetamol vs NSAIDs

3

432

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.92, 1.44]

2 Vomiting Show forest plot

11

856

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.89, 1.55]

2.1 Paracetamol vs NSAIDs

8

424

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [0.77, 1.68]

2.2 Propacetamol vs NSAIDs

3

432

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [0.81, 1.81]

3 Nausea/vomiting Show forest plot

8

408

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.62, 1.97]

3.1 Paracetamol vs NSAIDs

4

208

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.42, 2.39]

3.2 Propacetamol vs NSAIDs

4

200

Risk Ratio (M‐H, Fixed, 95% CI)

1.2 [0.55, 2.60]

4 Pruritus Show forest plot

8

558

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.69, 1.34]

4.1 Paracetamol vs NSAIDs

5

286

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.75, 1.51]

4.2 Propacetamol vs NSAIDs

3

272

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.37, 1.60]

5 Respiratory depression Show forest plot

9

510

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.17, 3.26]

5.1 Paracetamol vs NSAIDs

8

470

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.17, 3.26]

5.2 Propacetamol vs NSAIDs

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Sedation Show forest plot

6

278

Risk Ratio (M‐H, Fixed, 95% CI)

2.6 [0.63, 10.75]

6.1 Paracetamol vs NSAIDs

4

208

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.07, 14.90]

6.2 Propacetamol vs NSAIDs

2

70

Risk Ratio (M‐H, Fixed, 95% CI)

3.67 [0.63, 21.22]

7 Urinary retention Show forest plot

6

390

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.51, 2.32]

7.1 Paracetamol vs NSAIDs

4

178

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.24, 4.02]

7.2 Propacetamol vs NSAIDs

2

212

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [0.47, 2.78]

8 Allergy/skin rash/local reaction Show forest plot

8

399

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.24, 2.26]

8.1 Paracetamol vs NSAIDs

6

290

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.26, 4.02]

8.2 Propacetamol vs NSAIDs

2

109

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.04, 3.16]

Figuras y tablas -
Comparison 17. Individual adverse events: paracetamol or propacetamol vs NSAIDs
Comparison 18. Individual adverse events: paracetamol or propacetamol vs opioids

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Nausea Show forest plot

6

545

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.24, 0.65]

1.1 Paracetamol vs opioids

4

438

Risk Ratio (M‐H, Fixed, 95% CI)

0.31 [0.17, 0.56]

1.2 Propacetamol vs opioids

2

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.32, 1.91]

2 Vomiting Show forest plot

5

495

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.12, 0.72]

2.1 Paracetamol vs opioids

3

388

Risk Ratio (M‐H, Fixed, 95% CI)

0.25 [0.08, 0.71]

2.2 Propacetamol vs opioids

2

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.10, 2.62]

3 Nausea/vomiting Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.15, 1.64]

3.1 Propacetamol vs opioids

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.15, 1.64]

4 Pruritus Show forest plot

3

157

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.21, 1.43]

4.1 Paracetamol vs opioids

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.27, 8.22]

4.2 Propacetamol vs opioids

2

107

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.10, 1.19]

5 Respiratory depression Show forest plot

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.1 Paracetamol vs opioids

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Sedation Show forest plot

3

354

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.03, 0.34]

6.1 Paracetamol vs opioids

3

354

Risk Ratio (M‐H, Fixed, 95% CI)

0.10 [0.03, 0.34]

Figuras y tablas -
Comparison 18. Individual adverse events: paracetamol or propacetamol vs opioids
Comparison 19. Individual adverse events: paracetamol vs ketamine

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Nausea Show forest plot

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.66, 1.30]

2 Vomiting Show forest plot

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.22, 1.33]

3 Sedation Show forest plot

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.13, 71.51]

Figuras y tablas -
Comparison 19. Individual adverse events: paracetamol vs ketamine