Single dose oral diclofenac for acute postoperative pain in adults

3.2 Diclofenac K 6 591 Risk Ratio (M-H, Fixed, 95% CI) 5.02 [3.71, 6.78]Comparison 4.Diclofenac versus placeboOutcome or subgroup titleNo. ofstudiesNo. ofparticipants Statistical method Effect size1 Participants with at least one 12 Risk Ratio (M-H, Fixed, 95% CI) Subtotals onlyadverse event1.1 Diclofenac 25 mg 4 502 Risk Ratio (M-H, Fixed, 95% CI) 1.15 [0.63, 2.11]1.2 Diclofenac 50 mg 9 1116 Risk Ratio (M-H, Fixed, 95% CI) 1.00 [0.65, 1.55]1.3 Diclofenac 100 mg 7 792 Risk Ratio (M-H, Fixed, 95% CI) 1.04 [0.79, 1.39]2 Participants using rescue 10 Risk Ratio (M-H, Fixed, 95% CI) Subtotals onlymedication at 6 hours2.1 Diclofenac 25 mg 4 504 Risk Ratio (M-H, Fixed, 95% CI) 0.72 [0.63, 0.82]2.2 Diclofenac 50 mg 8 930 Risk Ratio (M-H, Fixed, 95% CI) 0.50 [0.44, 0.58]2.3 Diclofenac 100 mg 6 637 Risk Ratio (M-H, Fixed, 95% CI) 0.48 [0.41, 0.56]Analysis 1.1.Comparison 1 Diclofenac 25 mg v placebo, Outcome 1 Participants with at least 50% painrelief over 4 to 6 hours.Review:Single dose oral diclofenac for acute postoperative pain in adultsComparison:1 Diclofenac 25 mg v placeboOutcome:1 Participants with at least 50% pain relief over 4 to 6 hoursStudy or subgroup Diclofenac 25 mg Placebo Risk Ratio Weight Risk Ration/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CIHersh 2004 34/63 11/68 29.0 % 3.34 [ 1.85, 6.00 ]Kubitzek 2003 42/83 7/84 19.0 % 6.07 [ 2.90, 12.73 ]Nelson 1994 23/50 4/50 10.9 % 5.75 [ 2.14, 15.42 ]Olson 1997 32/52 15/52 41.1 % 2.13 [ 1.32, 3.44 ]Total (95% CI) 248 254 100.0 % 3.63 [ 2.64, 4.98 ]Total events: 131 (Diclofenac 25 mg), 37 (Placebo)Heterogeneity: Chi 2 = 7.52, df = 3 (P = 0.06); I 2 =60%Test for overall effect: Z = 7.95 (P < 0.00001)Test for subgroup differences: Not applicable0.1 0.2 0.5 1 2 5 10Favours placeboFavours diclofenacSingle dose oral diclofenac for acute postoperative pain in adults (Review)Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.36