• Acta Anaesthesiol Scand · Nov 2021

    Review

    Paracetamol, NSAIDs, and glucocorticoids for postoperative pain: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis.

    • Emma Ritsmer Stormholt, Joakim Steiness, Bauer DerbyCecilieCCentre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark., Esta LarsenMiaMCentre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.Department of Anaesthesiology, Herlev and Gentofte Hospital, Herlev, Denmark., Mathias Maagaard, and Ole Mathiesen.
    • Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.
    • Acta Anaesthesiol Scand. 2021 Nov 1; 65 (10): 1505-1513.

    BackgroundMultimodal analgesia is the leading principle for managing postoperative pain. Recent guidelines recommend combinations of paracetamol and a non-steroidal anti-inflammatory drug (NSAID) for most surgeries. Glucocorticoids have been used for decades due to their potent anti-inflammatory and antipyretic properties. Subsequently, glucocorticoids may improve postoperative analgesia. We will perform a systematic review to assess benefits and harms of adding glucocorticoids to paracetamol and NSAIDs. We expect to uncover pros and cons of the addition of glucocorticoid to the basic standard regimen of paracetamol and NSAIDs for postoperative analgesia.MethodThis protocol for a systematic review was written according to the The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will search for trials in the following electronic databases: Medline, CENTRAL, CDSR and Embase. Two authors will independently screen trials for inclusion using Covidence, extract data and assess risk of bias using Cochrane's ROB 2 tool. We will analyse data using Review Manager and Trial Sequential Analysis. Meta-analysis will be performed according to the Cochrane guidelines and results will be validated according to the eight-step procedure suggested by Jakobsen et al We will present our primary findings in a 'summary of findings' table. We will evaluate the overall certainty of evidence using the GRADE approach.DiscussionThis review will aim to explore the combination of glucocorticoids together with paracetamol and NSAIDs for postoperative pain. We will attempt to provide reliable evidence regarding the role of glucocorticoids as part of a multimodal analgesic regimen in combination with paracetamol and NSAID.© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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