Intravenous Acetaminophen (Paracetamol) for Post-Craniotomy Pain; Systematic Review and Meta-analysis of Randomized Clinical Trials
Abstract
BACKGROUND
Acute pain control after supratentorial craniotomy is considered among the most important indicators of postoperative recovery. The aim of the current study was to determine the effects of intravenous acetaminophen on post-craniotomy pain.
METHODS
We searched databases including EMBASE, Scopus, MEDLINE, Cochrane Library, and Web of Science databases until April 2019. Cochran's Q test and I-square (I2) statistic were used to assess the heterogeneity exists across included clinical trials. Standardized mean difference (SMD) and 95% CI between were used to estimate pooled effect sizes.
RESULTS
Out of 479 reports, 5 RCTs met the inclusion criteria and were appropriate for our meta-analysis which included a total number of 2635 patients. The pooled results of included clinical trials indicated that paracetamol intake significantly decreased rescue dose (SMD=-0.67; 95% CI, -1.15, -0.19; P<0.01; I2: 90.0%), total dosage of rescue (SMD=-0.78; 95% CI, -1.18, -0.37; P<0.01; I2: 86.0%), ICU length of stay (SMD=-0.24; 95% CI, -0.44, -0.04; P=0.01; I2: 0.0%), and visual analogue scale (SMD=-0.16; 95% CI, -0.31, -0.00; P=0.04; I2: 71.7%) and increased patient satisfaction (SMD=0.28; 95% CI, 0.14, 0.43; P<0.01; I2: 10.2%) among patients with craniotomy. Time to rescue (SMD=0.21; 95% CI, -0.42, 0.85; P=0.51; I2: 94.3%) and hospital length of stay (SMD=-0.04; 95% CI, -0.24, 0.16; P=0.69; I2: 0.0%) did not significantly change following paracetamol intake.
CONCLUSION
The results of…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,635 participants or records.
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