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Paracetamol for pain relief after surgical removal of lower wisdom teeth

The surgical removal of wisdom teeth (third molars) is the most commonly performed surgical procedure undertaken in oral surgery practice. Postoperative complications may include swelling, bruising and limited mouth opening but patients are most often concerned about postoperative pain, which may be severe. Paracetamol is effective in relieving pain with a low incidence of adverse effects. It is one of the most commonly used analgesics and is widely available without prescription around the world. In this review we investigated the optimal dose of paracetamol and the optimal time for drug administration to provide pain relief after the surgical removal of wisdom teeth. The side effects of different doses of the drug were also explored.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Acetaminophen for osteoarthritis

Fifteen studies of moderate to high quality were reviewed and provide the best evidence we have today. The studies tested almost 6000 people with osteoarthritis of the hip or knee. The studies compared people who took 4000 mg of acetaminophen (Tylenol, Paracetamol) a day to people who took a placebo (fake pill) or non‐steroidal anti‐inflammatory drugs (NSAIDs). Most studies lasted on average about 6 weeks.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Paracetamol for low back pain

To see how well paracetamol works for non‐specific low back pain (LBP). Non‐specific LBP is back pain for which there is no identified disease or condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Painkillers, such as paracetamol and ibuprofen, before dental treatment in children and adolescents for reducing pain after treatment

Dental pain is common after dental procedures and can lead to increased fear of dental treatment, avoidance of dental treatment and other associated problems. Reduction of pain is important, particularly in children and adolescents. One way of managing this might be to give painkillers before treatment so that the painkillers can start to work right away.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Paracetamol for cancer pain

There is no evidence to show that paracetamol is useful in treating people with cancer pain, either alone or combined with a morphine‐like drug. Nor is there evidence to disprove that it is useful. There are no good studies evaluating paracetamol for management of cancer pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Alternating and combined antipyretics for treatment of fever in children

When they are ill with infections, children often develop a fever. The fever with common viral illnesses, such as colds, coughs, sore throats and gastrointestinal illness, usually lasts a few days, makes children feel unwell, and is distressing for the children, their parents, or other caregivers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Tramadol for osteoarthritis

There is gold level evidence that to treat osteoarthritis, tramadol taken for up to three months may decrease pain, may improve stiffness and function and overall‐well being. Tramadol may cause side effects such as nausea, vomiting, dizziness, constipation, tiredness, and headache.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Beta2‐adrenoceptor agonists for primary dysmenorrhoea

As many as 50% of premenopausal women regularly suffer from menstrual pain. Many of these women may be incapacitated for one to three days during each menstrual cycle. Primary dysmenorrhoea (PD) is where women suffer from menstrual pain but lack any pathology in their pelvic anatomy. A wide range of treatments are available and some of these, such as beta2‐adrenoceptor agonists, have been used to treat women with primary dysmenorrhoea but their effects are unclear. Five studies involving 187 females with an age range of 15 to 40 years were included in this review. Oral isoxsuprine was examined in two studies; terbutaline oral spray, ritodrine chloride and oral hydroxyphenyl‐orciprenalin were compared with placebo in a further three studies. All of the studies were conducted over 30 years ago and none were of high quality. None of these medications, other than isoxsuprine combined with acetaminophen and caffeine, were reported to have any beneficial effect. Side effects with these medications were reported in up to a quarter of the participants and included nausea, vomiting, dizziness, quivering, tremor and palpitations. At present there is insufficient evidence to allow confident decision‐making about the use of beta2‐adrenoceptor agonists for dysmenorrhoea.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Caffeine as an analgesic adjuvant for acute pain in adults

Caffeine is found in various plant products, and may be ingested in drinks like tea, coffee, and some soft drinks and energy drinks. Caffeine is a stimulant, and can improve alertness and prevent tiredness over short periods. It may disturb sleep in some people if taken before bed. Ordinary consumption of caffeine (less than 500 milligrams daily) is not harmful to health. Caffeine is commonly used in pain‐relieving medicines available from pharmacies without a prescription. An adjuvant is something that is added to a medicine to make it work better.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Physical methods for treating fever in children

Plain language summary pending.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Pain relievers for children with acute middle ear infection

We wanted to find out if pain relievers are effective for relieving pain in children with acute middle ear infection (acute otitis media (AOM)) and which medications, alone or together, provide the most effective pain relief.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Postoperative pain relief for children

Pain is commonly experienced after surgery. Children tend to rely on a parent or carer to give medication to help relieve the pain. Medication can either be given when the child complains of pain (as required), or 'around the clock' (fixed schedule, e.g. every four hours).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Interventions for relieving the pain and discomfort of screening mammography

Breast cancer is the most common cancer affecting women. Screening for breast cancer by means of regular mammograms reduces the death rate from this disease. In the screening process, women who have no symptoms of disease undergo a mammogram, which can identify those who might have breast cancer. Mammography uses X‐rays to find early breast cancers. In order to obtain an accurate reading, the mammography machine needs to compress the breasts. This can cause discomfort or pain, and some women decide not to have mammograms because they can be painful. In some mammography studies, up to 35% of women report pain with the procedure.This review tried to identify and assess clinical studies of interventions designed to reduce the pain or discomfort that women can experience during mammography. A set of quality criteria were decided to ensure that only studies that were relevant and well designed were included in this review. Seven studies met these criteria and were included. The studies involved a wide range of interventions to relieve the pain and discomfort of screening mammography, such as providing women with verbal and/or written information before the procedure, or pain relief medication taken before the examination, use of a breast cushion (to pad the surface of the mammography equipment), patient‐controlled compression of the breast, and reduced compression by the technician. The studies assessed the pain the women expected, and actually experienced, by means of a range of questionnaires of differing quality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Pre‐transfusion drugs for preventing side effects from blood transfusions

Febrile non‐haemolytic transfusion reactions (FNHTRs) and allergic reactions are the most common adverse reactions to blood transfusion. These reactions are often related to other dangerous side effects from transfusion such as sepsis due to contaminated blood products and intravascular red cell haemolysis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Antibiotic use for severe toothache (irreversible pulpitis)

Irreversible pulpitis occurs where the dental pulp (tissue inside the tooth which contains the nerve) has been damaged beyond repair. It is characterised by intense pain (toothache), sufficient to wake someone up at night and is considered to be one of the most frequent reasons that patients attend for emergency dental care. Any tooth may be affected, it is not restricted to particular age groups, and it usually occurs as a direct result of dental decay, a cracked tooth or trauma and thus tends to occur more frequently in older patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Drug combinations for chronic neuropathic pain in adults

Neuropathic pain – due to nerve disease or damage – is often treated by pain medications which have limited effect and/or dose‐related side effects when given alone. Combinations of more than one drug are often used with the goal of achieving better pain relief or fewer side effects (if the pain relieving effects of the combined drugs are more additive than the side effects), or both. Despite evidence that over 45% of individuals suffering from neuropathic pain take two or more drugs for their pain, we could find only 21 high‐quality studies of various different systemic and topical drug combinations. Given the wide possible variety of different drug combinations and the small number of studies, results for neuropathic pain from this review are insufficient to suggest the value of any one specific drug combination. However, the publication of multiple high‐quality studies suggesting the superiority of some drug combinations, together with evidence that drug combinations are widely used in clinical practice, underline the importance of conducting more combination studies with improved methodology.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Low back pain: Medication for chronic back pain

Over-the-counter painkillers can sometimes relieve chronic low back pain. Studies have also found that some prescription painkillers like opioids may have a benefit. There is no proof that muscle relaxants or antidepressants help relieve chronic low back pain.Low back pain is one of the ten most common diagnoses made by family doctors. It often goes away on its own without treatment, but sometimes it persists or keeps coming back. The causes of chronic low back pain are usually unclear, and treating it is often difficult.Good-quality studies have so far found that only few treatments help. Besides medication, treatments such as exercise therapy, psychological therapy, physiotherapy and acupuncture are used. The medications used include over-the-counter and prescription painkillers, muscle relaxants and antidepressants.Because medication can have side effects – especially when taken over longer periods of time – experts recommend not taking it continuously, but rather only for a short while, for example if the pain is especially severe.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 2, 2015

Cooling therapy for acute stroke

Stroke is a life‐threatening event in which part of the brain stops functioning properly, because it either does not receive blood and oxygen or it is damaged by bleeding from a ruptured blood vessel. Interventions to reduce temperature may protect brain tissue from damage during stroke. Previous studies have shown that patients with a lower body temperature at the time of stroke have a better outcome than those with a higher body temperature. To reduce death or disability, temperature‐lowering therapy is used in open‐heart surgery, after cardiac arrest and in babies who may have suffered from a lack of oxygen at birth. By contrast, the therapeutic effect of temperature‐lowering therapy in patients with traumatic brain injury is less promising. Besides its potential beneficial effects, temperature‐lowering therapy may have adverse effects including chest infection, venous thrombosis or cardiac arrhythmias. This review aimed to assess the potential benefits and risks of temperature‐lowering therapy in patients with acute stroke. All studies that compared the use of physical or pharmacological temperature‐lowering therapies on acute stroke with usual medical management in acute stroke patients were considered. Physical temperature‐lowering techniques included cooling blankets, cooling fluids, cooling helmets and other devices. Pharmacological temperature‐lowering interventions included drugs used to reduce temperature. The results of the five included pharmacological and three physical temperature reduction trials, involving 423 participants with acute stroke, do not indicate a clinical benefit or harm. Both interventions were associated with a slight increase in the occurrence of infections, but this was not statistically significant. A clinically significant effect of temperature‐lowering therapy on outcome after stroke was not demonstrated, but cannot be ruled out. Large clinical trials are therefore needed to assess the effect of temperature‐lowering therapies in acute stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Use of drug and non‐drug interventions to reduce pain associated with rocuronium bromide injection in patients undergoing general anaesthesia

Rocuronium bromide is a muscle relaxant used as part of general anaesthesia for surgery. Muscle relaxants are used to relax the muscles of the airway to enable endotracheal intubation (placing a breathing tube in the windpipe to support the airway while the person is unconscious) and to facilitate the surgery. However, rocuronium bromide can cause intense pain as it is injected in some people. We wanted to find out whether giving another drug, such as a painkiller or another anaesthetic, or a non‐drug intervention, such as diluting the rocuronium, would be useful in reducing the pain experienced by some people on injection of rocuronium.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Oral ibuprofen for acute treatment of episodic tension‐type headache in adults

Frequent episodic tension‐type headache (TTH) means having between one and 14 headaches per month. The condition causes much disability, and stops people concentrating and working properly. When headaches occur the pain usually goes away over time.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

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