TY - JOUR
T1 - Paracetamol, non-steroidal anti-inflammatory drugs and glucocorticoids for postoperative pain
T2 - A protocol for a systematic review with meta-analysis and trial sequential analysis
AU - Ritsmer Stormholt, Emma
AU - Steiness, Joakim
AU - Bauer Derby, Cecilie
AU - Esta Larsen, Mia
AU - Maagaard, Mathias
AU - Mathiesen, Ole
N1 - Publisher Copyright:
© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
PY - 2021/11
Y1 - 2021/11
N2 - Background: Multimodal analgesia is the leading principle for managing postoperative pain. Recent guidelines recommend combinations of paracetamol and a non-steroidal anti-inflammatory drug (NSAID) for most surgeries. Glucocorticoids have been used for decades due to their potent anti-inflammatory and antipyretic properties. Subsequently, glucocorticoids may improve postoperative analgesia. We will perform a systematic review to assess benefits and harms of adding glucocorticoids to paracetamol and NSAIDs. We expect to uncover pros and cons of the addition of glucocorticoid to the basic standard regimen of paracetamol and NSAIDs for postoperative analgesia. Method: This protocol for a systematic review was written according to the The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will search for trials in the following electronic databases: Medline, CENTRAL, CDSR and Embase. Two authors will independently screen trials for inclusion using Covidence, extract data and assess risk of bias using Cochrane's ROB 2 tool. We will analyse data using Review Manager and Trial Sequential Analysis. Meta-analysis will be performed according to the Cochrane guidelines and results will be validated according to the eight-step procedure suggested by Jakobsen et al We will present our primary findings in a ‘summary of findings’ table. We will evaluate the overall certainty of evidence using the GRADE approach. Discussion: This review will aim to explore the combination of glucocorticoids together with paracetamol and NSAIDs for postoperative pain. We will attempt to provide reliable evidence regarding the role of glucocorticoids as part of a multimodal analgesic regimen in combination with paracetamol and NSAID.
AB - Background: Multimodal analgesia is the leading principle for managing postoperative pain. Recent guidelines recommend combinations of paracetamol and a non-steroidal anti-inflammatory drug (NSAID) for most surgeries. Glucocorticoids have been used for decades due to their potent anti-inflammatory and antipyretic properties. Subsequently, glucocorticoids may improve postoperative analgesia. We will perform a systematic review to assess benefits and harms of adding glucocorticoids to paracetamol and NSAIDs. We expect to uncover pros and cons of the addition of glucocorticoid to the basic standard regimen of paracetamol and NSAIDs for postoperative analgesia. Method: This protocol for a systematic review was written according to the The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will search for trials in the following electronic databases: Medline, CENTRAL, CDSR and Embase. Two authors will independently screen trials for inclusion using Covidence, extract data and assess risk of bias using Cochrane's ROB 2 tool. We will analyse data using Review Manager and Trial Sequential Analysis. Meta-analysis will be performed according to the Cochrane guidelines and results will be validated according to the eight-step procedure suggested by Jakobsen et al We will present our primary findings in a ‘summary of findings’ table. We will evaluate the overall certainty of evidence using the GRADE approach. Discussion: This review will aim to explore the combination of glucocorticoids together with paracetamol and NSAIDs for postoperative pain. We will attempt to provide reliable evidence regarding the role of glucocorticoids as part of a multimodal analgesic regimen in combination with paracetamol and NSAID.
KW - Acetaminophen/therapeutic use
KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
KW - Glucocorticoids
KW - Humans
KW - Meta-Analysis as Topic
KW - Pain, Postoperative/drug therapy
KW - Pharmaceutical Preparations
KW - Systematic Reviews as Topic
UR - http://www.scopus.com/inward/record.url?scp=85114945865&partnerID=8YFLogxK
U2 - 10.1111/aas.13943
DO - 10.1111/aas.13943
M3 - Review
C2 - 34138463
AN - SCOPUS:85114945865
SN - 0001-5172
VL - 65
SP - 1505
EP - 1513
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 10
ER -