Single dose oral diclofenac for acute postoperative pain in adults

Analysis 4.2.Comparison 4 Diclofenac versus placebo, Outcome 2 Participants using rescue medication at6 hours.Review:Single dose oral diclofenac for acute postoperative pain in adultsComparison:4 Diclofenac versus placeboOutcome:2 Participants using rescue medication at 6 hoursStudy or subgroup Diclofenac Placebo Risk Ratio Weight Risk Ration/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI1 Diclofenac 25 mgHersh 2004 32/63 54/68 29.1 % 0.64 [ 0.49, 0.84 ]Kubitzek 2003 64/83 75/84 41.8 % 0.86 [ 0.75, 0.99 ]Nelson 1994 29/51 33/51 18.5 % 0.88 [ 0.64, 1.20 ]Olson 1997 2/52 19/52 10.6 % 0.11 [ 0.03, 0.43 ]Subtotal (95% CI) 249 255 100.0 % 0.72 [ 0.63, 0.82 ]Total events: 127 (Diclofenac), 181 (Placebo)Heterogeneity: Chi 2 = 16.03, df = 3 (P = 0.001); I 2 =81%Test for overall effect: Z = 4.94 (P < 0.00001)2 Diclofenac 50 mgAhlstrom 1993 14/35 23/30 8.0 % 0.52 [ 0.33, 0.82 ]Bakshi 1992 22/54 14/23 6.4 % 0.67 [ 0.42, 1.06 ]Bakshi 1992 17/51 13/23 5.8 % 0.59 [ 0.35, 1.00 ]Bakshi 1994 20/83 53/82 17.3 % 0.37 [ 0.25, 0.56 ]Herbertson 1995 26/52 43/52 13.9 % 0.60 [ 0.45, 0.82 ]Hersh 2004 25/68 54/68 17.5 % 0.46 [ 0.33, 0.65 ]Mehlisch 1995 26/53 44/52 14.4 % 0.58 [ 0.43, 0.78 ]Nelson 1994 20/51 33/51 10.7 % 0.61 [ 0.41, 0.90 ]Olson 1997 2/50 19/52 6.0 % 0.11 [ 0.03, 0.45 ]Subtotal (95% CI) 497 433 100.0 % 0.50 [ 0.44, 0.58 ]Total events: 172 (Diclofenac), 296 (Placebo)Heterogeneity: Chi 2 = 11.81, df = 8 (P = 0.16); I 2 =32%Test for overall effect: Z = 9.91 (P < 0.00001)3 Diclofenac 100 mgHerbertson 1995 28/52 43/52 18.4 % 0.65 [ 0.49, 0.86 ]Hersh 2004 21/66 54/68 22.7 % 0.40 [ 0.28, 0.58 ]Mehlisch 1995 16/52 44/52 18.8 % 0.36 [ 0.24, 0.56 ]Nelson 1994 16/51 33/51 14.1 % 0.48 [ 0.31, 0.76 ]0.05 0.2 1 5 20Favours diclofenacFavours placebo(Continued ...)Single dose oral diclofenac for acute postoperative pain in adults (Review)Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.45