Review: a single dose of oral naproxen or naproxen sodium reduced acute postoperative pain in adults

摘要

Pain remains under-treated in postoperative settings despite evidence of the effectiveness of specific treatments. In determining the efficacy, duration of action, and adverse effects of naproxen, a commonly prescribed non-steroidal anti-inflammatory drug (NSAID), the review by Mason ef al presents clinicians with an alternative treatment to opioids for moderate to severe postoperative pain. The review addresses concerns about respiratory depression and impaired gastric motility associated with opioids.2 In considering this alternative, however, clinicians need to balance the benefits of opiate-sparing effects and the possibility of adverse effects.Individuals have varying pain tolerances and may respond dissimilarly to different NSAIDs. The review provides comprehensive information on the effects of a single dose of naproxen or naproxen sodium-information that will be useful to clinicians managing patients who fail to respond to other prescribed NSAIDs or are prescribed lower or higher doses of naproxen or naproxen sodium.Importantly, the meta-analyses showed significant pain relief with single dose usage. As well, the weighted mean time to remedication was 7.5 hours with naproxen sodium, 550 mg, compared with 2.6 hours with placebo. During heavy clinical workloads, less frequent medication requirements could help nurses to improve pain management and benefit patients who often wait for long periods after assessment for administration of pain medication. Although it is not uncommon to use a cut point of 50% pain relief in analyses of treatment effects, nurses should remember the subjective nature of pain and the potential negative effects of lower levels of pain on activities of daily living in some patients with lower pain thresholds. This again underscores the need for individual pain assessment.The systematic review by Mason ef al also highlights the inadequacy of available data on adverse events. Future studies of pain management need to include clear detailed reporting of patient withdrawals by treatment group.