Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults


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Bottom line

This review found that most people with moderate or severe pain after an operation get good pain relief from taking ketoprofen 50 mg or dexketoprofen 25 mg.

Background

Acute pain is short-lived pain often felt soon after injury, including after operations. Most people who have an operation have moderate or severe pain afterwards. Painkillers are tested in people with acute pain, often following the removal of wisdom teeth. This pain is usually treated with painkillers taken by mouth. We believe these results can be applied to other acute painful conditions.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are painkillers that usually provide good pain relief to a high proportion of people with moderate or severe pain after an operation when taken by mouth by people who are able to swallow. This review updated the evidence on two closely related NSAIDs, ketoprofen and dexketoprofen. Ketoprofen has two forms, one of which, dexketoprofen, is the form that produces pain relief.

Study characteristics

In March 2017, we found 24 studies involving 5220 people. The main comparison was between usual oral doses of ketoprofen 50 mg and placebo, and dexketoprofen 25 mg and placebo. The studies tested single doses after wisdom tooth extraction, and after other types of surgery, mainly hip replacement and gynaecological operations. Studies included adults over a range of ages, and 7 out of 10 participants were women. The main outcome was participants having at least half of the maximum possible pain relief over the first six hours after taking the tablets.

Key results

For ketoprofen, there were 594 participants in eight studies in the comparison with placebo (a dummy tablet). About 6 in 10 achieved at least half of the maximum possible pain relief with ketoprofen 50 mg compared with 2 in 10 with placebo. The number of participants who needed more painkillers within six hours was 5 in 10 with ketoprofen compared with 8 in 10 with placebo.

For dexketoprofen, there were 1177 participants in eight studies in the comparison with placebo. About 5 in 10 achieved at least half of the maximum possible pain relief with dexketoprofen 25 mg compared with 3 in 10 with placebo. The number of participants who needed more painkillers within six hours was 5 in 10 with dexketoprofen compared with 7 in 10 with placebo.

About 1 or 2 in 10 people had any side effects with ketoprofen, dexketoprofen, or placebo. Serious side effects were uncommon. Few people dropped out of the studies for any reason.

Quality of the evidence

The quality of the evidence was judged to be high for most outcomes. This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different is low.