Project: Treatments for Acute Pain: A Systematic Review
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Project Summary

Title and Description

Title

Treatments for Acute Pain: A Systematic Review

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Description

To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids.

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Contributor(s)

Roger Chou, M.D. Jesse Wagner, M.A. Azrah Y. Ahmed, B.A. Ian Blazina, M.P.H. Erika Brodt, B.S. David I. Buckley, M.D., M.P.H. Tamara P. Cheney, M.D. Esther Choo, M.D., M.P.H. Tracy Dana, M.L.S. Debra Gordon, R.N., D.N.P., FANN Saurabh Khandelwal , M.D. Shelby Kantner, B.A. Marian S. McDonagh, Pharm.D. Christine Sedgley, M.D.S., M.D.Sc., FRACDS, MRACDS (ENDO), FACD, Ph.D. Andrea C. Skelly, Ph.D., M.P.H.

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Methodology

Electronic databases (Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) were searched through August 5, 2020 for relevant publications. Searches were supplemented by reviewing reference lists and a Federal Register Notice. Randomized controlled trials (RCTs) of opioid therapy versus nonopioid pharmacologic or nonpharmacologic therapy, nonopioid therapy versus nonpharmacologic therapy, nonpharmacologic therapy versus inactive controls (placebo, sham therapy, attention control, or a minimal intervention), and head-to-head trials of nonopioid pharmacologic and nonpharmacologic therapy were selected using predefined criteria and dual review. Observational studies on the association between being prescribed opioids for acute pain versus no opioids and on factors influencing opioid prescribing for acute pain conditions were also included. This review focused on eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain (excluding inpatient management of pain after major surgical procedures), dental pain, pain due to kidney stones, and pain due to sickle cell disease. The review focused on outpatient management or therapy initiated shortly before discharge (e.g., after surgery or in emergency department). Outcomes were analyzed at <1 day, 1 day to <1 week, 1 week to <2 weeks, 2 to <4 weeks, and ≥4 weeks. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain and likelihood of repeat or rescue medication use and adverse events. Otherwise, meta-analyses were not conducted due to small number of studies, methodological limitations and study heterogeneity. The magnitude of effects was classified as small, moderate or large using previously defined criteria, and strength of evidence was assessed.

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DOI

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Funding Source

AHRQ Contract No. 290-2015-00009-I

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Notes

https://doi.org/10.23970/AHRQEPCCER240 Data was entered retrospectively by importing data from Microsoft Excel. Data tables can be downloaded using the following links: https://effectivehealthcare.ahrq.gov/products/treatments-acute-pain/research https://srdr.s3.amazonaws.com/uploads/01-03-2021/Treatments+for+Acute+Pain+SR+PMIDs_12.15.20.docx https://srdr.s3.amazonaws.com/uploads/01-03-2021/Treatments+for+Acute+Pain_Appendix+E_Evidence+Tables_12.18.20.xlsx https://srdr.s3.amazonaws.com/uploads/01-03-2021/Treatments+for+Acute+Pain_Appendix+F_Risk+of+Bias+Assessment_12.18.20.xlsx Table E-1. Key Question 1 Evidence Table Table E-2. Key Question 1 Long-term Use Evidence Table Table E-3. Key Question 2 Evidence Table Table E-4. Key Question 3 Evidence Table Table E-5. Key Question 4 Evidence Table Table E-6. Key Question 5 Evidence Table Table E-7. Key Question 5 Long-term Use Evidence Table Table E-8. Key Question 6 Evidence Table Table E-9. Key Question 6 Long-term Use Evidence Table Table E-10. Key Question 7 Evidence Table Table E-11. Key Question 8 Evidence Table Table F-1. Quality Assessment for Randomized Controlled Trials Table F-2. Quality Assessment for Observational Studies

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Key Questions

Acute back pain (including back pain with radiculopathy)

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Acute neck pain (including neck pain with radiculopathy)

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Musculoskeletal pain not otherwise included in KQ1 or KQ2 (including fractures)

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Peripheral neuropathic pain (related to herpes zoster and trigeminal neuralgia)

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Postoperative pain (excluding inpatient management of pain following major surgical procedures)

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Dental pain (surgical and nonsurgical)

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Kidney stones (including inpatient management)

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Sickle cell crisis (episodic pain)

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For each key question, the following sub-questions were addressed: Opioid Therapy a. What is the comparative effectiveness of opioid therapy versus: (1) nonopioid pharmacologic therapy (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], antidepressants, anticonvulsants) or (2) nonpharmacologic therapy (e.g., exercise, cognitive behavioral therapy, acupuncture) for outcomes related to pain, function, pain relief satisfaction, and quality of life and after followup at the following intervals: less than 1 day;, 1 day to less than 1 week;, 1 week to less than 2 weeks;, 2 weeks to less than 4 weeks,; 4 weeks or longer? b. How does effectiveness of opioid therapy vary depending on: (1) patient demographics (e.g., age, race, ethnicity, gender); (2) patient medical or psychiatric comorbidities; (3) dose of opioids; (4) duration of opioid therapy, including number of opioid prescription refills and quantity of pills used; (5) opioid use history; (6) substance use history; (7) use of concomitant therapies? c. What are the harms of opioid therapy versus nonopioid pharmacologic therapy, or nonpharmacologic therapy with respect to: (1) misuse, opioid use disorder, and related outcomes; (2) overdose; (3) other harms, including gastrointestinal-related harms, falls, fractures, motor vehicle accidents, endocrinological harms, infections, cardiovascular events, cognitive harms, and psychological harms (e.g., depression)? d. How do harms vary depending on: (1) patient demographics (e.g., age, gender); (2) patient medical or psychiatric comorbidities; (3) the dose of opioid used; (4) the duration of opioid therapy; (5) opioid use history; or (6) substance use history? e. What are the effects of prescribing opioid therapy versus not prescribing opioid therapy for acute pain on (1) short-term (<3 months) continued need for prescription pain relief, such as need for opioid refills, and (2) long-term opioid use (3 months or greater)? f. For patients with acute pain being considered for opioid therapy, what is the accuracy of instruments for predicting risk of opioid misuse, opioid use disorder, or overdose? g. For patients with acute pain being considered for opioid therapy, what is the effectiveness of instruments for predicting risk of opioid misuse, opioid use disorder, or overdose? h. For patients with acute pain being considered for opioid therapy, what is the effect of the following factors on the decision to prescribe opioids: (1) existing opioid management plans; (2) patient education; (3) clinician and patient values and preferences related to opioids; (4) urine drug screening; (5) use of prescription drug monitoring program data; (6) availability of close followup? Nonopioid Pharmacologic Therapy i. What is the comparative effectiveness of nonopioid pharmacologic therapy (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], antidepressants, anticonvulsants) versus: (1) other nonopioid pharmacologic treatments, such as those in a different medication class;, or (2) nonpharmacologic therapy for outcomes related to pain, function, pain relief satisfaction, and quality of life after followup at the following intervals: less than <1 day;, 1 day to less than <1 week,; 1 week to less than <2 weeks,; 2 weeks to less than 4 weeks,; 4 weeks or longer? j. How does effectiveness of nonopioid pharmacologic therapy vary depending on: (1) patient demographics (e.g., age, race, ethnicity, gender); (2) patient medical and psychiatric comorbidities; (3) the type of nonopioid medication; (4) dose of medication; (5) duration of treatment? k. What are the harms of nonopioid pharmacologic therapy versus other nonopioid pharmacologic therapy, or nonpharmacologic therapy with respect to: (1) misuse;, (2) overdose; (3) other harms, including gastrointestinal-related harms, cardiovascular-related harms, kidney-related harms, falls, fractures, motor vehicle accidents, endocrinological harms, infections, cognitive harms, and psychological harms (e.g., depression)? l. How do harms vary depending on: (1) patient demographics (e.g., age, gender); (2) patient medical comorbidities; (3) the type of nonopioid medication; (4) dose of medication; (5) the duration of therapy? Nonpharmacologic Therapy m. What is the comparative effectiveness of nonpharmacologic therapy versus sham treatment, waitlist, usual care, attention control, and no treatment after followup at the following intervals: less than 1 day,; 1 day to less than 1 week,; 1 week to less than 2 weeks,; 2 weeks to less than 4 weeks,; 4 weeks or longer? n. What is the comparative effectiveness of nonpharmacologic treatments (e.g., exercise, cognitive behavioral therapy, acupuncture) for outcomes related to pain, function, pain relief satisfaction, and quality of life after followup at the following intervals: less than 1 day,; 1 day to less than 1 week,; 1 week to less than 2 weeks,; 2 weeks to less than 4 weeks,; 4 weeks or longer? o. How does effectiveness of nonpharmacologic therapy vary depending on: (1) patient demographics (e.g., age, gender); (2) patient medical and psychiatric comorbidities? p. How do harms vary depending on: (1) patient demographics (e.g., age, gender); (2) patient medical and psychiatric comorbidities; (3) the type of treatment used; (4) the frequency of therapy; (5) the duration of therapy?

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Associated Extraction Forms

Title	Created by	Key Questions Addressed	Form Notes
Extraction Form for Key Questions 1-8	Azrah Ahmed	1, 2, 3, 4, 5, 6, 7, 8

Associated Studies (each link opens a new tab)

Title	Author	Year
The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study.	Dehghan M., Farahbod F.	2014
Tapentadol, oxycodone or placebo for acute pain of vertebral compression fractures: a randomized Phase IIIb study.	Vorsanger GJ., Farrell J., Xiang J., Chow W., Moskovitz BL., Rosenthal NR.	2013
Back pain: a randomized clinical trial of rotational manipulation of the trunk.	Glover JR., Morris JG., Khosla T.	1974
Acute back pain and spasm. A controlled multicenter trial of combined analgesic and antispasm agents.	Basmajian JV.	1989
Tapentadol immediate release versus oxycodone immediate release for treatment of acute low back pain.	Biondi D., Xiang J., Benson C., Etropolski M., Moskovitz B., Rauschkolb C.	-- Not Found --
Comparison of diflunisal and acetaminophen with codeine in the treatment of initial or recurrent acute low back strain.	Brown FL., Bodison S., Dixon J., Davis W., Nowoslawski J.	1986
Relative effectiveness of an extension program and a combined program of manipulation and flexion and extension exercises in patients with acute low back syndrome.	Erhard RE., Delitto A., Cibulka MT.	1994
Medicines of choice in low back pain.	Evans DP., Burke MS., Newcombe RG.	1980
Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain: A Randomized Clinical Trial.	Friedman BW., Dym AA., Davitt M., Holden L., Solorzano C., Esses D., Bijur PE., Gallagher EJ.	2015
Clinical trial of common treatments for low back pain in family practice.	Gilbert JR., Taylor DW., Hildebrand A., Evans C.	1985
Electroacupuncture compared with paracetamol for acute low back pain.	Hackett GI., Seddon D., Kaminski D.	1988
A benefit of spinal manipulation as adjunctive therapy for acute low-back pain: a stratified controlled trial.	Hadler NM., Curtis P., Gillings DB., Stinnett S.	1987
Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial.	Hancock MJ., Maher CG., Latimer J., McLachlan AJ., Cooper CW., Day RO., Spindler MF., McAuley JH.	2007
Acupuncture for acute non-specific low back pain: a randomised, controlled, double-blind, placebo trial.	Hasegawa TM., Baptista AS., de Souza MC., Yoshizumi AM., Natour J.	2014
A new skeletal muscle relaxant (DS 103-282) compared to diazepam in the treatment of muscle spasm of local origin.	Hennies OL.	1981
Westeinde sciatica trial: randomized controlled study of bed rest and physiotherapy for acute sciatica.	Hofstee DJ., Gijtenbeek JM., Hoogland PH., van Houwelingen HC., Kloet A., Lötters F., Tans JT.	2002
A randomized clinical trial comparing chiropractic adjustments to muscle relaxants for subacute low back pain.	Hoiriis KT., Pfleger B., McDuffie FC., Cotsonis G., Elsangak O., Hinson R., Verzosa GT.	-- Not Found --
Ketorolac versus acetaminophen-codeine in the emergency department treatment of acute low back pain.	Innes GD., Croskerry P., Worthington J., Beveridge R., Jones D.	-- Not Found --
A randomised controlled trial of spinal manipulative therapy in acute low back pain.	Jüni P., Battaglia M., Nüesch E., Hämmerle G., Eser P., van Beers R., Vils D., Bernhard J., Ziswiler HR., Dähler M., Reichenbach S., Villiger PM.	2009
Impact of continuous low level heatwrap therapy in acute low back pain patients: subjective and objective measurements.	Kettenmann B., Wille C., Lurie-Luke E., Walter D., Kobal G.	2007
The treatment of acute low back pain--bed rest, exercises, or ordinary activity?	Malmivaara A., Häkkinen U., Aro T., Heinrichs ML., Koskenniemi L., Kuosma E., Lappi S., Paloheimo R., Servo C., Vaaranen V.	1995
Continuous low-level heatwrap therapy for treating acute nonspecific low back pain.	Nadler SF., Steiner DJ., Erasala GN., Hengehold DA., Abeln SB., Weingand KW.	2003
Overnight use of continuous low-level heatwrap therapy for relief of low back pain.	Nadler SF., Steiner DJ., Petty SR., Erasala GN., Hengehold DA., Weingand KW.	2003
Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.	Santilli V., Beghi E., Finucci S.	-- Not Found --
Continuous low-level heatwrap therapy relieves low back pain and reduces muscle stiffness.	Stark J., Petrofsky J., Berk L., Bains G., Chen S., Doyle G.	2014
A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace.	Tao XG., Bernacki EJ.	2005
The use of a back class teaching extension exercises in the treatment of acute low back pain in primary care.	Underwood MR., Morgan J.	1998
Acupuncture in patients with acute low back pain: a multicentre randomised controlled clinical trial.	Vas J., Aranda JM., Modesto M., Benítez-Parejo N., Herrera A., Martínez-Barquín DM., Aguilar I., Sánchez-Araujo M., Rivas-Ruiz F.	2012
Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo.	von Heymann WJ., Schloemer P., Timm J., Muehlbauer B.	2013
Does 48 hours' bed rest influence the outcome of acute low back pain?	Wilkinson MJ.	1995
Effects of motion style acupuncture treatment in acute low back pain patients with severe disability: a multicenter, randomized, controlled, comparative effectiveness trial.	Shin JS., Ha IH., Lee J., Choi Y., Kim MR., Park BY., Shin BC., Lee MS.	2013
Manipulative therapy and clinical prediction criteria in treatment of acute nonspecific low back pain.	Hallegraeff JM., Hallegraeff HJ., de Greef M., Winters JC., Lucas C.	2009
Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial.	Kim HJ., Yi JM., Cho HG., Chang BS., Lee CK., Kim JH., Yeom JS.	2014
Influence of elastic lumbar support belts on trunk muscle function in patients with non-specific acute lumbar back pain.	Anders C., Hübner A.	2019
Extent and Impact of Opioid Prescribing for Acute Occupational Low Back Pain in the Emergency Department.	Lee SS., Choi Y., Pransky GS.	2016
Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use.	Webster BS., Verma SK., Gatchel RJ.	2007
Management of acute musculoskeletal conditions : thoracolumbar strain or sprain. A double-blind evaluation comparing the efficacy and safety of carisoprodol with diazepam.	Boyles W.	1983
Efficacy of spinal manual therapy in non-specific acute low back pain.	Hussain I, Hussain Shah SI, Amjad I.	2013
Clinical observation of a combination of acupuncture and drug administration for nonspecific acute lumbar sprain	Liu J, Li N.	2010
Efficacy of various forms of conservative treatment in low back pain. A comparative study.	Postacchini F, Facchini M, Palieri P.	1988
Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident.	Borchgrevink GE., Kaasa A., McDonagh D., Stiles TC., Haraldseth O., Lereim I.	1998
Randomised, controlled outcome study of active mobilisation compared with collar therapy for whiplash injury.	Schnabel M., Ferrari R., Vassiliou T., Kaluza G.	2004
Neck collar, "act-as-usual" or active mobilization for whiplash injury? A randomized parallel-group trial.	Kongsted A., Qerama E., Kasch H., Bendix T., Bach FW., Winther F., Korsholm L., Jensen TS.	2007
Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial.	Kuijper B., Tans JT., Beelen A., Nollet F., de Visser M.	2009
Efficacy of therapeutic ultrasound in pain and joint mobility in whiplash traumatic acute and subacute phases.	Ruiz-Molinero C., Jimenez-Rejano JJ., Chillon-Martinez R., Suarez-Serrano C., Rebollo-Roldan J., Perez-Cabezas V.	2014
A comparative study of flurbiprofen and aspirin in soft tissue trauma.	Muckle DS.	1976
A cooling method in the treatment of ankle sprains.	Basur RL., Shephard E., Mouzas GL.	1976
Use of rib belts in acute rib fractures.	Lazcano A., Dougherty JM., Kruger M.	1989
Clinical benefits of early cold therapy in accident and emergency following ankle sprain.	Sloan JP., Hain R., Pownall R.	1989
Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine.	Muncie HL., King DE., DeForge B.	1986
Comparison of diflunisal and acetaminophen with codeine in the management of grade 2 ankle sprain.	Aghababian RV.	1986
Ultrasound in the treatment of ankle sprains.	Williamson JB., George TK., Simpson DC., Hannah B., Bradbury E.	1986
Comparison of diclofenac sodium and aspirin in the treatment of acute sports injuries.	Duncan JJ., Farr JE.	-- Not Found --
Piroxicam in acute musculoskeletal disorders and sports injuries.	Heere LP.	1988
Comparison of diflunisal and acetaminophen with codeine in the treatment of mild to moderate pain due to strains and sprains.	Indelicato PA.	1986
Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain.	Ordog GJ.	1987
Naproxen and aspirin in acute musculoskeletal disorders: a double-blind, parallel study in patients with sports injuries.	Andersen LA., Gøtzsche PC.	1984
Cryotherapy in ankle sprains.	Hocutt JE., Jaffe R., Rylander CR., Beebe JK.	-- Not Found --
Tramadol versus hydrocodone-acetaminophen in acute musculoskeletal pain: a randomized, double-blind clinical trial.	Turturro MA., Paris PM., Larkin GL.	1998
Randomized controlled study of ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint.	Nyanzi CS., Langridge J., Heyworth JR., Mani R.	1999
Comparative efficacy of a proprietary topical ibuprofen gel and oral ibuprofen in acute soft tissue injuries: a randomized, double-blind study.	Whitefield M., O'Kane CJ., Anderson S.	2002
Randomized double-blind trial comparing oral paracetamol and oral nonsteroidal antiinflammatory drugs for treating pain after musculoskeletal injury.	Woo WW., Man SY., Lam PK., Rainer TH.	2005
Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains.	Dalton JD., Schweinle JE.	2006
Tramadol/acetaminophen or hydrocodone/acetaminophen for the treatment of ankle sprain: a randomized, placebo-controlled trial.	Hewitt DJ., Todd KH., Xiang J., Jordan DM., Rosenthal NR.	2007
The efficacy of paracetamol in the treatment of ankle sprains in comparison with diclofenac sodium.	Kayali C., Agus H., Surer L., Turgut A.	2007
The effect of add-on yogic prana energization technique (YPET) on healing of fresh fractures: a randomized control study.	Oswal P., Nagarathna R., Ebnezar J., Nagendra HR.	2011
Efficacy of paracetamol versus diclofenac for Grade II ankle sprains.	Lyrtzis C., Natsis K., Papadopoulos C., Noussios G., Papathanasiou E.	2011
Sublingual buprenorphine in acute pain management: a double-blind randomized clinical trial.	Jalili M., Fathi M., Moradi-Lakeh M., Zehtabchi S.	2012
Ibuprofen vs acetaminophen vs their combination in the relief of musculoskeletal pain in the ED: a randomized, controlled trial.	Bondarsky EE., Domingo AT., Matuza NM., Taylor MB., Thode HC., Singer AJ.	2013
Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial.	Zhao M., Gao W., Zhang L., Huang W., Zheng S., Wang G., Hong BY., Tang B.	2018
Acetaminophen or Nonsteroidal Anti-Inflammatory Drugs in Acute Musculoskeletal Trauma: A Multicenter, Double-Blind, Randomized, Clinical Trial.	Ridderikhof ML., Lirk P., Goddijn H., Vandewalle E., Schinkel E., Van Dieren S., Kemper EM., Hollmann MW., Goslings JC.	2018
Efficacy of acetaminophen	AlRuthia Y., Alghadeer S., Balkhi B., Almalag HM., Alsobayel H., Alodaibi F., Alayoubi F., Alkhamali AS., Alshuwairikh S., Alqahtani FN., Alsanawi H.	2019
Feasibility Study Comparing Oral Paracetamol and Oral Non-Steroidal Anti-Inflammatory Drugs for Treating Pain after Musculoskeletal Injury: a Randomised, Double Blind, Controlled Trial	Man SY, Woo WK, Lam PKW, et al.	2004
Tramadol compared with diclofenac in traumatic musculoskeletal pain	Pagliara L, Tornago S, Metastasio J, et al.	1997
Ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint.	Zammit E, Herrington L.	2005
A randomized parallel trial of topical aspirin-moisturizer solution vs. oral aspirin for acute herpetic neuralgia.	Balakrishnan S., Bhushan K., Bhargava VK., Pandhi P.	2001
A randomized, placebo-controlled trial of oxycodone and of gabapentin for acute pain in herpes zoster.	Dworkin RH., Barbano RL., Tyring SK., Betts RF., McDermott MP., Pennella-Vaughan J., Bennett GJ., Berber E., Gnann JW., Irvine C., Kamp C., Kieburtz K., Max MB., Schmader KE.	2009
Ibuprofen and acetaminophen in the relief of postpartum episiotomy pain.	Schachtel BP., Thoden WR., Baybutt RI.	1989
The effect of cold therapy on pain, swelling, and range of motion after anterior cruciate ligament reconstructive surgery.	Daniel DM., Stone ML., Arendt DL.	1994
Ketorolac versus acetaminophen or ibuprofen in controlling postoperative pain in patients with strabismus.	Morrison NA., Repka MX.	1994
Ketoprofen, acetaminophen plus oxycodone, and acetaminophen in the relief of postoperative pain.	Sunshine A., Olson NZ., Zighelboim I., De Castro A.	1993
The use of cold therapy in the postoperative management of patients undergoing arthroscopic anterior cruciate ligament reconstruction.	Edwards DJ., Rimmer M., Keene GC.	-- Not Found --
The efficacy of cryotherapy in the postoperative shoulder.	Speer KP., Warren RF., Horowitz L.	-- Not Found --
Pressure on acupoints decreases postoperative pain.	Felhendler D., Lisander B.	1996
The efficacy of cryotherapy following arthroscopic knee surgery.	Lessard LA., Scudds RA., Amendola A., Vaz MD.	1997
Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction.	Barber FA., McGuire DA., Click S.	1998
Effects of cold and compression dressings on early postoperative outcomes for the arthroscopic anterior cruciate ligament reconstruction patient.	Dervin GF., Taylor DE., Keene GC.	1998
The effect of cryotherapy on intraarticular temperature and postoperative care after anterior cruciate ligament reconstruction.	Ohkoshi Y., Ohkoshi M., Nagasaki S., Ono A., Hashimoto T., Yamane S.	-- Not Found --
The effect of foot massage on patients' perception of care following laparoscopic sterilization as day case patients.	Hulme J., Waterman H., Hillier VF.	1999
A prospective, randomized comparison of dexketoprofen, ketoprofen or paracetamol for postoperative analgesia after outpatient knee arthroscopy.	Berti M., Albertin A., Casati A., Palmisano S., Municino G., da Gama Malcher M., De Ponti A.	-- Not Found --
Postoperative analgesia at home after ambulatory hand surgery: a controlled comparison of tramadol, metamizol, and paracetamol.	Rawal N., Allvin R., Amilon A., Ohlsson T., Hallén J.	2001
Efficacy and tolerability of celecoxib versus hydrocodone/acetaminophen in the treatment of pain after ambulatory orthopedic surgery in adults.	Gimbel JS., Brugger A., Zhao W., Verburg KM., Geis GS.	2001
Transcutaneous electrical nerve stimulation for postoperative pain relief after total knee arthroplasty.	Breit R., Van der Wall H.	2004
Postoperative arm massage: a support for women with lymph node dissection.	Forchuk C., Baruth P., Prendergast M., Holliday R., Bareham R., Brimner S., Schulz V., Chan YC., Yammine N.	-- Not Found --
Controlled-release oxycodone is better tolerated than intravenous tramadol/metamizol for postoperative analgesia after retinal-surgery.	Kaufmann J., Yesiloglu S., Patermann B., Krombach J., Kiencke P., Kampe S.	2004
Cryo/Cuff compared to epidural anesthesia after knee unicompartmental arthroplasty: a prospective, randomized and controlled study of 60 patients with a 6-week follow-up.	Holmström A., Härdin BC.	2005
Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial.	Nilsson U., Unosson M., Rawal N.	2005
Cooling for the reduction of postoperative pain: prospective randomized study.	Koç M., Tez M., Yoldaş O., Dizen H., Göçmen E.	2006
A randomized, double-blind, phase III study comparing multiple doses of tapentadol IR, oxycodone IR, and placebo for postoperative (bunionectomy) pain.	Daniels SE., Upmalis D., Okamoto A., Lange C., Häeussler J.	2009
A randomized, double-blind, placebo-controlled phase 3 study of the relative efficacy and tolerability of tapentadol IR and oxycodone IR for acute pain.	Daniels S., Casson E., Stegmann JU., Oh C., Okamoto A., Rauschkolb C., Upmalis D.	2009
Effectiveness of foot and hand massage in postcesarean pain control in a group of Turkish pregnant women.	Degirmen N., Ozerdogan N., Sayiner D., Kosgeroglu N., Ayranci U.	2010
A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction.	Sniezek PJ., Brodland DG., Zitelli JA.	2011
Randomized sham-controlled trial of acupuncture for postoperative pain control after stapled haemorrhoidopexy.	Langenbach MR., Aydemir-Dogruyol K., Issel R., Sauerland S.	2012
Effect of foot and hand massage in post-cesarean section pain control: a randomized control trial.	Abbaspoor Z., Akbari M., Najar S.	2014
Auricular acupressure for analgesia in perioperative period of total knee arthroplasty.	He BJ., Tong PJ., Li J., Jing HT., Yao XM.	2013
Immediate-release tapentadol or oxycodone for treatment of acute postoperative pain after elective arthroscopic shoulder surgery: a randomized, phase IIIb study.	Vorsanger GJ., Klopfer AM., Xiang J., Benson CJ., Moskovitz BL., Rosenthal NR.	-- Not Found --
Effectiveness of cryotherapy after anterior cruciate ligament reconstruction.	Dambros C., Martimbianco AL., Polachini LO., Lahoz GL., Chamlian TR., Cohen M.	2012
Transcutaneous electrical nerve stimulation for pain relief after liposuction: a randomized controlled trial.	da Silva MP., Liebano RE., Rodrigues VA., Abla LE., Ferreira LM.	2015
Effect of postoperative analgesia on acute and persistent postherniotomy pain: a randomized study.	Bugada D., Lavand'homme P., Ambrosoli AL., Klersy C., Braschi A., Fanelli G., Saccani Jotti GM., Allegri M.	2015
The Effectiveness of Neck Stretching Exercises Following Total Thyroidectomy on Reducing Neck Pain and Disability: A Randomized Controlled Trial.	Ayhan H., Tastan S., Iyigün E., Oztürk E., Yildiz R., Görgülü S.	2016
Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial.	Saatsaz S., Rezaei R., Alipour A., Beheshti Z.	2016
A Randomized, Double-Blind, Placebo-Controlled Study of Neuromuscular Electrical Stimulation (NMES) use for Recovery after Elective Total Hip Replacement Surgery.	Castellano JJ., Rojas AM., Karia R., Hunter T., Slover J., Moroz A.	2016
Pain Relief After Operative Treatment of an Extremity Fracture: A Noninferiority Randomized Controlled Trial.	Helmerhorst GTT., Zwiers R., Ring D., Kloen P.	2017
Do Selective COX-2 Inhibitors Affect Pain Control and Healing After Arthroscopic Rotator Cuff Repair? A Preliminary Study.	Oh JH., Seo HJ., Lee YH., Choi HY., Joung HY., Kim SH.	2018
Reduced opiate use after total knee arthroplasty using computer-assisted cryotherapy.	Thijs E., Schotanus MGM., Bemelmans YFL., Kort NP.	2019
A randomized controlled trial comparing tapentadol with oxycodone in non-breastfeeding women post elective cesarean section.	Ffrench-O'Carroll R., Steinhaeuser H., Duff S., Close J., McNamara J., Ahmed N., Murray M., Rice T., Immanni S.	2019
The Effect of Foot Massage on Postoperative Pain and Anxiety Levels in Laparoscopic Cholecystectomy Surgery: A Randomized Controlled Experimental Study.	Koraş K., Karabulut N.	2019
A Randomized Single-Blinded Trial of Ibuprofen- versus Opioid-Based Primary Analgesic Therapy in Outpatient Otolaryngology Surgery.	Nguyen KK., Liu YF., Chang C., Park JJ., Kim CH., Hondorp B., Vuong C., Xu H., Crawley BK., Simental AA., Church CA., Inman JC.	2019
Tapentadol immediate release for moderate to severe acute post-surgery pain.	Viscusi ER., Allard R., Sohns M., Eerdekens M.	-- Not Found --
Efficacy of Hand and Foot Massage in Anxiety and Pain Management Following Laparoscopic Cholecystectomy: A Controlled Randomized Study.	Sözen KK., Karabulut N.	2020
Survey of Postoperative Pain in Photorefractive Keratectomy Using Topical versus Oral Nonsteroidal Anti-Inflammatory Drugs.	Ripa M., Betts B., Dhaliwal S., Wang K., Pouly S., Chen D., Mifflin M.	2020
Long-term analgesic use after low-risk surgery: a retrospective cohort study.	Alam A., Gomes T., Zheng H., Mamdani MM., Juurlink DN., Bell CM.	2012
Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery.	Stucke RS., Kelly JL., Mathis KA., Hill MV., Barth RJ.	2018
Chronic use of tramadol after acute pain episode: cohort study.	Thiels CA., Habermann EB., Hooten WM., Jeffery MM.	2019
Post-operative pain management through audio-analgesia: Investigating musical constructs.	Finlay KA, Wilson JA, Gaston P, et al.	2016
Acupuncture as a complement to the pharmacological management of pain, nausea and vomiting after cesarean section: a randomized clinical trial.	Gamermann PW, Martins ALC, Rosa L, et al.	2014
The comparative efficacy of diclofenac potassium, aspirin, and placebo in the treatment of patients with pain following gynecologic surgery	Hebertson RM, Storey N.	1995
Analgesic efficacy of acetaminophen 1000 mg, acetaminophen 2000 mg, and the combination of acetaminophen 1000 mg and codeine phosphate 60 mg versus placebo in acute postoperative pain.	Skoglund LA., Skjelbred P., Fyllingen G.	1991
The analgesic efficacy of flurbiprofen compared to acetaminophen with codeine.	Cooper SA., Kupperman A.	1991
Evaluation of ketorolac, ibuprofen, acetaminophen, and an acetaminophen-codeine combination in postoperative oral surgery pain.	Forbes JA., Kehm CJ., Grodin CD., Beaver WT.	1990
Multicenter clinical trial of ibuprofen and acetaminophen in the treatment of postoperative dental pain.	Mehlisch DR., Sollecito WA., Helfrick JF., Leibold DG., Markowitz R., Schow CE., Shultz R., Waite DE.	1990
Ibuprofen and acetaminophen in the relief of acute pain: a randomized, double-blind, placebo-controlled study.	Cooper SA., Schachtel BP., Goldman E., Gelb S., Cohn P.	1989
Double-blind comparison of meclofenamate sodium with acetaminophen, acetaminophen with codeine and placebo for relief of postsurgical dental pain.	Cooper SA., Firestein A., Cohn P.	1988
Comparative study of flurbiprofen, zomepirac sodium, acetaminophen plus codeine, and acetaminophen for the relief of postsurgical dental pain.	Sunshine A., Marrero I., Olson N., McCormick N., Laska EM.	1986
The additive analgesic efficacy of acetaminophen, 1000 mg, and codeine, 60 mg, in dental pain.	Bentley KC., Head TW.	1987
Analgesic efficacy of an ibuprofen-codeine combination.	Cooper SA., Engel J., Ladov M., Precheur H., Rosenheck A., Rauch D.	-- Not Found --
The relative efficacy of indoprofen compared with opioid-analgesic combinations.	Cooper SA., Breen JF., Giuliani RL.	1981
Evaluation of oxycodone and acetaminophen in treatment of postoperative dental pain.	Cooper SA., Precheur H., Rauch D., Rosenheck A., Ladov M., Engel J.	1980
Efficacy of Chinese acupuncture on postoperative oral surgery pain.	Lao L., Bergman S., Langenberg P., Wong RH., Berman B.	1995
A single-dose, double-blind comparison of naproxen sodium, acetaminophen, and placebo in postoperative dental pain.	Kiersch TA., Halladay SC., Hormel PC.	-- Not Found --
Analgesic efficacy of flurbiprofen in comparison with acetaminophen, acetaminophen plus codeine, and placebo after impacted third molar removal.	Dionne RA., Snyder J., Hargreaves KM.	1994
Comparative study of ibuprofen lysine and acetaminophen in patients with postoperative dental pain.	Mehlisch DR., Jasper RD., Brown P., Korn SH., McCarroll K., Murakami AA.	-- Not Found --
Tramadol hydrochloride: analgesic efficacy compared with codeine, aspirin with codeine, and placebo after dental extraction.	Moore PA., Crout RJ., Jackson DL., Schneider LG., Graves RW., Bakos L.	1998
A comparison of ketorolac tromethamine and acetaminophen codeine in the management of acute apical periodontitis.	Sadeghein A., Shahidi N., Dehpour AR.	1999
Combining diclofenac with acetaminophen or acetaminophen-codeine after oral surgery: a randomized, double-blind single-dose study.	Breivik EK., Barkvoll P., Skovlund E.	1999
Evaluation of the combination of flurbiprofen and tramadol for management of endodontic pain.	Doroschak AM., Bowles WR., Hargreaves KM.	1999
Upside assay sensitivity in a dental pain model.	Breivik EK., Haanaes HR., Barkvoll P.	1998
Ibuprofen liquigel for oral surgery pain.	Hersh EV., Levin LM., Cooper SA., Doyle G., Waksman J., Wedell D., Hong D., Secreto SA.	2000
Pregabalin in patients with postoperative dental pain.	Hill CM., Balkenohl M., Thomas DW., Walker R., Mathé H., Murray G.	2001
Onset of analgesia for liquigel ibuprofen 400 mg, acetaminophen 1000 mg, ketoprofen 25 mg, and placebo in the treatment of postoperative dental pain.	Olson NZ., Otero AM., Marrero I., Tirado S., Cooper S., Doyle G., Jayawardena S., Sunshine A.	2001
A randomized, double-blind, parallel-group study comparing the analgesic effect of etoricoxib to placebo, naproxen sodium, and acetaminophen with codeine using the dental impaction pain model.	Malmstrom K., Kotey P., Coughlin H., Desjardins PJ.	-- Not Found --
A randomized observer blind comparison of bilateral facial ice pack therapy with no ice therapy following third molar surgery.	van der Westhuijzen AJ., Becker PJ., Morkel J., Roelse JA.	2005
Combination oxycodone 5 mg/ibuprofen 400 mg for the treatment of postoperative pain: a double-blind, placebo- and active-controlled parallel-group study.	Van Dyke T., Litkowski LJ., Kiersch TA., Zarringhalam NM., Zheng H., Newman K.	2004
Effect of ice compression on pain after mandibular third molar surgery: a single-blind, randomized controlled trial.	Forouzanfar T., Sabelis A., Ausems S., Baart JA., van der Waal I.	2008
Onset of analgesia with sodium ibuprofen, ibuprofen acid incorporating poloxamer and acetaminophen--a single-dose, double-blind, placebo-controlled study in patients with post-operative dental pain.	Daniels S., Reader S., Berry P., Goulder M.	2009
Effects of combination treatment with ketoprofen 100 mg + acetaminophen 1000 mg on postoperative dental pain: a single-dose, 10-hour, randomized, double-blind, active- and placebo-controlled clinical trial.	Akural EI., Järvimäki V., Länsineva A., Niinimaa A., Alahuhta S.	2009
Comparison of the analgesic efficacy of concurrent ibuprofen and paracetamol with ibuprofen or paracetamol alone in the management of moderate to severe acute postoperative dental pain in adolescents and adults: a randomized, double-blind, placebo-controlled, parallel-group, single-dose, two-center, modified factorial study.	Mehlisch DR., Aspley S., Daniels SE., Bandy DP.	2010
Evaluation of the dose range of etoricoxib in an acute pain setting using the postoperative dental pain model.	Daniels SE., Bandy DP., Christensen SE., Boice J., Losada MC., Liu H., Mehta A., Peloso PM.	2011
Effects of three oral analgesics on postoperative pain following root canal preparation: a controlled clinical trial.	Mehrvarzfar P., Abbott PV., Saghiri MA., Delvarani A., Asgar K., Lotfi M., Karamifar K., Kharazifard MJ., Khabazi H.	2012
Evaluation of multiday analgesia with etoricoxib in a double-blind, randomized controlled trial using the postoperative third-molar extraction dental pain model.	Brown JD., Daniels SE., Bandy DP., Ko AT., Gammaitoni A., Mehta A., Boice JA., Losada MC., Peloso PM.	2013
Dexketoprofen/tramadol: randomised double-blind trial and confirmation of empirical theory of combination analgesics in acute pain.	Moore RA., Gay-Escoda C., Figueiredo R., Tóth-Bagi Z., Dietrich T., Milleri S., Torres-Lagares D., Hill CM., García-García A., Coulthard P., Wojtowicz A., Matenko D., Peñarrocha-Diago M., Cuadripani S., Pizà-Vallespir B., Guerrero-Bayón C., Bertolotti M., Contini MP., Scartoni S., Nizzardo A., Capriati A., Maggi CA.	2015
Effectiveness of cold therapy in reducing pain, trismus, and oedema after impacted mandibular third molar surgery: a randomized, self-controlled, observer-blind, split-mouth clinical trial.	Zandi M., Amini P., Keshavarz A.	2016
Efficacy of disintegrating aspirin in two different models for acute mild-to-moderate pain: sore throat pain and dental pain.	Voelker M., Schachtel BP., Cooper SA., Gatoulis SC.	2016
Oral health-related quality of life following third molar surgery with or without application of ice pack therapy.	Ibikunle AA., Adeyemo WL.	2016
Efficacy of oral diclofenac with or without codeine for pain control after invasive bilateral third molar extractions.	Zupelari-Goncalves P., Weckwerth GM., Calvo AM., Simoneti LF., Dionisio TJ., Brozoski DT., Torres EA., Lauris JRP., Faria FAC., Santos CF.	2017
Effect of Diclofenac Mouthwash on Postoperative Pain after Periodontal Surgery.	Mishra A., Amalakara J., Avula H., Reddy K.	2017
Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial.	Santini MF., Rosa RAD., Ferreira MBC., Fischer MI., Souza EM., Só MVR.	-- Not Found --
Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: A double blind randomized controlled trial.	Akinbade AO., Ndukwe KC., Owotade FJ.	2019
Efficacy and safety of naproxen sodium 440 mg versus acetaminophen 600 mg/codeine phosphate 60 mg in the treatment of postoperative dental pain.	Cattry E., Troullos E., Paredes-Diaz A.	2020
Efficacy and Safety of Single and Multiple Doses of a Fixed-dose Combination of Ibuprofen and Acetaminophen in the Treatment of Postsurgical Dental Pain: Results From 2 Phase 3, Randomized, Parallel-group, Double-blind, Placebo-controlled Studies.	Searle S., Muse D., Paluch E., Leyva R., DePadova E., Cruz-Rivera M., Kellstein D.	2020
Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists.	Rasubala L., Pernapati L., Velasquez X., Burk J., Ren YF.	2015
Persistent Opioid Use After Wisdom Tooth Extraction.	Harbaugh CM., Nalliah RP., Hu HM., Englesbe MJ., Waljee JF., Brummett CM.	2018
Efficacy of Ice Pack Therapy After Impacted Third Molar Surgery: A Randomized Controlled Clinical Trial.	Altiparmak N, Bayram B, Diker N, et al.	2018
Single-dose therapy with diclofenac potassium, aspirin, or placebo following dental impaction surgery	Mehlisch DR, Brown P.	1995
An evaluation of the analgesic efficacy of diclofenac potassium, aspirin, and placebo in postoperative dental pain	Nelson S, Brahmin J.	1994
Comparative study of the efficacy of dipyrone, diclofenac sodium and pethidine in acute renal colic. Collaborative Group of the Spanish Society of Clinical Pharmacology.	-- Not Found --	1991
A multi-centre comparative study of diclofenac sodium and a dipyrone/spasmolytic combination, and a single-centre comparative study of diclofenac sodium and pethidine in renal colic patients in India.	Marthak KV., Gokarn AM., Rao AV., Sane SP., Mahanta RK., Sheth RD., Chavda KD., Rane BS., Vaidya AB.	1991
A double-blind single dose comparison of intramuscular ketorolac tromethamine and pethidine in the treatment of renal colic.	Oosterlinck W., Philp NH., Charig C., Gillies G., Hetherington JW., Lloyd J.	1990
Prospective double-blind comparison of buprenorphine and pethidine in ureteric colic.	Finlay IG., Scott R., McArdle CS.	1982
A comparison of intramuscular ketorolac and pethidine in the alleviation of renal colic.	Sandhu DP., Iacovou JW., Fletcher MS., Kaisary AV., Philip NH., Arkell DG.	1994
Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic.	Cordell WH., Wright SW., Wolfson AB., Timerding BL., Maneatis TJ., Lewis RH., Bynum L., Nelson DR.	1996
Comparative study of the efficacy of lysine acetylsalicylate, indomethacin and pethidine in acute renal colic.	al-Sahlawi KS., Tawfik OM.	1996
Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic.	Larkin GL., Peacock WF., Pearl SM., Blair GA., D'Amico F.	1999
Paracetamol vs piroxicam to relieve pain in renal colic. Results of a randomized controlled trial.	Grissa MH., Claessens YE., Bouida W., Boubaker H., Boudhib L., Kerkeni W., Boukef R., Nouira S.	2011
Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic.	Kaynar M., Koyuncu F., Buldu İ., Tekinarslan E., Tepeler A., Karatağ T., İstanbulluoğlu MO., Ceylan K.	2015
Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial.	Pathan SA., Mitra B., Straney LD., Afzal MS., Anjum S., Shukla D., Morley K., Al Hilli SA., Al Rumaihi K., Thomas SH., Cameron PA.	2016
Combining 1000 mg oral acetaminophen with 75 mg intramuscular diclofenac of analgesic efficacy for acute renal colic treatment.	Narci H, Ugur M, Uzun H, et al.	2012
Comparison of intramuscular analgesic activity of butorphanol and morphine in patients with sickle cell disease.	Gonzalez ER., Ornato JP., Ware D., Bull D., Evens RP.	1988
Efficacy of tramadol vs meperidine in vasoocclusive sickle cell crisis.	Uzun B., Kekec Z., Gurkan E.	2010
A randomized controlled pilot study feasibility of a tablet-based guided audio-visual relaxation intervention for reducing stress and pain in adults with sickle cell disease.	Ezenwa MO., Yao Y., Engeland CG., Molokie RE., Wang ZJ., Suarez ML., Wilkie DJ.	2016

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Project: Treatments for Acute Pain: A Systematic Review Public Report Complete

Project: Treatments for Acute Pain: A Systematic Review

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Project: Treatments for Acute Pain: A Systematic Review
Public Report Complete