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What relieves pain after surgery

For relief after surgery, some commonly used pain relievers work well for a large proportion of people, but some barely work at all, according to a new report.

Scientists reviewed about 350 randomized trials of oral pain medications used after surgery. The researchers included only high-quality studies that relied on standardized methods for reporting pain relief and side effects.
 
The trials involved about 45,000 patients, and researchers found reliable results for 46 drug doses and combinations. They defined a drug or combination as effective if it provided 50 percent pain relief for four to six hours after a single dose, compared with placebos.

By that standard, the researchers found that among the most effective drugs for the largest number of people were ketoprofen, which is sold as Orudis; 600 milligrams of ibuprofen; 1,200 milligrams of aspirin; and combinations of Tylenol with either ibuprofen, codeine or oxycodone. Codeine alone and lower doses of ibuprofen were largely ineffective.

“Of the analgesics you can get over the counter, the best combination is ibuprofen and Tylenol — 200 milligrams of ibuprofen and 500 of Tylenol has a 74 percent success rate,” said the lead author, Andrew Moore of the University of Oxford, adding, “Nothing works for everyone.”

The analysis appeared in the September issue of The Cochrane Library.

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