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Single dose oral diflunisal for acute postoperative pain in adults

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ver la versión actual 14 abril 2010

Appendices

Appendix 1. MEDLINE search strategy (via OVID)

  1. diflunisal [single term MESH]

  2. diflunisal

  3. OR/1‐2

  4. PAIN, POSTOPERATIVE [single term MeSH]

  5. ((postoperative adj4 pain$) or (post‐operative adj4 pain$) or post‐operative‐pain$ or (post$ NEAR pain$) or (postoperative adj4 analgesi$) or (post‐operative adj4 analgesi$) or ("post‐operative analgesi$"))  [in title, abstract or keywords]

  6. ((post‐surgical adj4 pain$) or ("post surgical" adj4 pain$) or (post‐surgery adj4 pain$))[in title, abstract or keywords]

  7. (("pain‐relief after surg$") or ("pain following surg$") or ("pain control after")) [in title, abstract or keywords]

  8. (("post surg$" or post‐surg$) AND (pain$ or discomfort)) [in title, abstract or keywords]

  9. ((pain$ adj4 "after surg$") or (pain$ adj4 "after operat$") or (pain$ adj4 "follow$ operat$") or (pain$ adj4 "follow$ surg$"))[in title, abstract or keywords]

  10. ((analgesi$ adj4 "after surg$") or (analgesi$ adj4 "after operat$") or (analgesi$ adj4 "follow$ operat$") or (analgesi$ adj4 "follow$ surg$"))

  11. OR/4‐10

  12. randomized controlled trial.pt.

  13. controlled clinical trial.pt.

  14. randomized controlled trials.sh.

  15. random allocation.sh.

  16. double‐blind method.sh.

  17. clinical trial.pt.

  18. exp clinical trials/

  19. (clin$ adj25 trial$) [in title, abstract or keywords]

  20. ((doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)) [in title, abstract or keywords]

  21. placebos.sh.

  22. placebo$ [in title, abstract or keywords]

  23. random$ [in title, abstract or keywords]

  24. research design.sh.

  25. OR/12‐24

  26. 3 AND 11 AND 25

Appendix 2. Glossary

Categorical rating scale: The commonest is the five category scale (none, slight, moderate, good or lots, and complete). For analysis numbers are given to the verbal categories (for pain intensity, none=0, mild=1, moderate=2 and severe=3, and for relief none=0, slight=1, moderate=2, good or lots=3 and complete=4). Data from different subjects is then combined to produce means (rarely medians) and measures of dispersion (usually standard errors of means). The validity of converting categories into numerical scores was checked by comparison with concurrent visual analogue scale measurements. Good correlation was found, especially between pain relief scales using cross‐modality matching techniques. Results are usually reported as continuous data, mean or median pain relief or intensity. Few studies present results as discrete data, giving the number of participants who report a certain level of pain intensity or relief at any given assessment point. The main advantages of the categorical scales are that they are quick and simple. The small number of descriptors may force the scorer to choose a particular category when none describes the pain satisfactorily.

VAS: Visual analogue scale: lines with left end labelled "no relief of pain" and right end labelled "complete relief of pain", seem to overcome this limitation. Patients mark the line at the point which corresponds to their pain. The scores are obtained by measuring the distance between the no relief end and the patient's mark, usually in millimetres. The main advantages of VAS are that they are simple and quick to score, avoid imprecise descriptive terms and provide many points from which to choose. More concentration and coordination are needed, which can be difficult post‐operatively or with neurological disorders.

TOTPAR: Total pain relief (TOTPAR) is calculated as the sum of pain relief scores over a period of time. If a patient had complete pain relief immediately after taking an analgesic, and maintained that level of pain relief for six hours, they would have a six‐hour TOTPAR of the maximum of 24. Differences between pain relief values at the start and end of a measurement period are dealt with by the trapezoidal rule.

SPID: Sumed pain intensity difference (SPID) is calculated as the sum of the differences between the pain scores over a period of time. Differences between pain intensity values at the start and end of a measurement period are dealt with by the trapezoidal rule.

VAS TOTPAR and VAS SPID are visual analogue versions of TOTPAR and SPID.

See "Measuring pain" in Bandolier's Little Book of Pain, Oxford University Press, Oxford. 2003; pp 7‐13.