PaPaS Opioids Special Collection

***The Cochrane PaPaS Group closes on 31 March 2023 and this website will be archived; please contact support@cochrane.org with any questions***

At PaPaS, we have produced many reviews on opioids, and we are pleased to share them here as a collection.

1. Cancer pain

2. Chronic non-cancer pain

3. Acute pain

4. Children and adolescents

1. Cancer pain

Buprenorphine for treating cancer pain

Schmidt‐Hansen M, Bromham N, Taubert M, Arnold S, Hilgart JS. Buprenorphine for treating cancer pain. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD009596. DOI: 10.1002/14651858.CD009596.pub4

Review objectives: To assess the effectiveness and tolerability of buprenorphine for pain in adults and children with cancer
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Codeine, alone and with paracetamol (acetaminophen), for cancer pain

Straube C, Derry S, Jackson KC, Wiffen PJ, Bell RF, Strassels S, Straube S. Codeine, alone and with paracetamol (acetaminophen), for cancer pain. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No.: CD006601. DOI: 10.1002/14651858.CD006601.pub4

Review objectives: To determine the efficacy and safety of codeine used alone or in combination with paracetamol for relieving cancer pain
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Hydromorphone for cancer pain

Bao YJ, Hou W, Kong XY, Yang L, Xia J, Hua BJ, Knaggs R. Hydromorphone for cancer pain. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD011108. DOI: 10.1002/14651858.CD011108.pub2

Review objectives: To determine the analgesic efficacy of hydromorphone in relieving cancer pain, as well as the incidence and severity of any adverse events
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Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain

Wiffen PJ, Derry S, Moore RA. Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD011056. DOI: 10.1002/14651858.CD011056.pub2

Review objectives: To determine the impact of opioid treatment on patient consciousness, appetite and thirst in randomised controlled trials of morphine, fentanyl, oxycodone or codeine for treating cancer pain
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Interventions for cough in cancer

Molassiotis A, Bailey C, Caress A, Tan J-Y. Interventions for cough in cancer. Cochrane Database of Systematic Reviews 2015, Issue 5. Art. No.: CD007881. DOI: 10.1002/14651858.CD007881.pub3

Review objectives: The primary objective was to determine the effectiveness of interventions, both pharmacological and non‐pharmacological, (other than chemotherapy and external beam radiotherapy) in the management of cough in malignant disease (especially in lung cancer)
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Ketamine as an adjuvant to opioids for cancer pain

Bell RF, Eccleston C, Kalso EA. Ketamine as an adjuvant to opioids for cancer pain. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD003351. DOI: 10.1002/14651858.CD003351.pub3

Review objectives: To determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults
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Methadone for cancer pain

Nicholson AB, Watson GR, Derry S, Wiffen PJ. Methadone for cancer pain. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD003971. DOI: 10.1002/14651858.CD003971.pub4

Review objectives: To determine the effectiveness and tolerability of methadone as an analgesic in adults and children with cancer pain
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Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care

Candy B, Jones L, Vickerstaff V, Larkin PJ, Stone P. Mu‐opioid antagonists for opioid‐induced bowel dysfunction in people with cancer and people receiving palliative care. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No.: CD006332. DOI: 10.1002/14651858.CD006332.pub3

Review objectives: To assess the effectiveness and safety of mu‐opioid antagonists for Opioid‐induced bowel dysfunction in people with cancer and people receiving palliative care
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Opioids for cancer pain - an overview of Cochrane reviews

Wiffen PJ, Wee B, Derry S, Bell RF, Moore RA. Opioids for cancer pain ‐ an overview of Cochrane reviews. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012592. DOI: 10.1002/14651858.CD012592.pub2

Review objectives: To provide an overview of the analgesic efficacy of opioids in cancer pain, and to report on adverse events associated with their use
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Oral morphine for cancer pain

Wiffen PJ, Wee B, Moore RA. Oral morphine for cancer pain. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD003868. DOI: 10.1002/14651858.CD003868.pub4

Review objectives: To determine the efficacy of oral morphine in relieving cancer pain, and to assess the incidence and severity of adverse events
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Oral tapentadol for cancer pain

Wiffen PJ, Derry S, Naessens K, Bell RF. Oral tapentadol for cancer pain. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD011460. DOI: 10.1002/14651858.CD011460.pub2

Review objectives: To assess the analgesic efficacy of tapentadol for the relief of cancer pain in adults, and the adverse events associated with its use in clinical trials
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Oxycodone for cancer-related pain

Schmidt‐Hansen M, Bennett MI, Arnold S, Bromham N, Hilgart JS. Oxycodone for cancer‐related pain. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD003870. DOI: 10.1002/14651858.CD003870.pub6

Review objectives: To assess the effectiveness and tolerability of oxycodone by any route of administration for pain in adults with cancer
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Tramadol with or without paracetamol (acetaminophen) for cancer pain

Wiffen PJ, Derry S, Moore RA. Tramadol with or without paracetamol (acetaminophen) for cancer pain. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No.: CD012508. DOI: 10.1002/14651858.CD012508.pub2

Review objectives: To assess the benefits and adverse effects of tramadol with or without paracetamol (acetaminophen) for cancer‐related pain
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Transdermal fentanyl for cancer pain

Hadley G, Derry S, Moore RA, Wiffen PJ. Transdermal fentanyl for cancer pain. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010270. DOI: 10.1002/14651858.CD010270.pub2

Review objectives: To determine the analgesic efficacy of transdermal fentanyl for relief of cancer pain, and to assess the adverse events associated with the use of transdermal fentanyl for relief of cancer pain
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2. Chronic non-cancer pain

Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews

Els C, Jackson TD, Kunyk D, Lappi VG, Sonnenberg B, Hagtvedt R, Sharma S, Kolahdooz F, Straube S. Adverse events associated with medium‐ and long‐term use of opioids for chronic non‐cancer pain: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2017, Issue 10. Art. No.: CD012509. DOI: 10.1002/14651858.CD012509.pub2

Review objectives: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium‐ or long‐term basis for the treatment of CNCP in adults
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Buprenorphine for neuropathic pain in adults

Wiffen PJ, Derry S, Moore RA, Stannard C, Aldington D, Cole P, Knaggs R. Buprenorphine for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD011603. DOI: 10.1002/14651858.CD011603.pub2

Review objectives: To assess the analgesic efficacy of buprenorphine for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials
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Combination pharmacotherapy for the treatment of neuropathic pain in adults

Chaparro LE, Wiffen PJ, Moore RA, Gilron I. Combination pharmacotherapy for the treatment of neuropathic pain in adults. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD008943. DOI: 10.1002/14651858.CD008943.pub2

Review objectives: This review evaluated the efficacy, tolerability and safety of various drug combinations for the treatment of neuropathic pain
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Combination pharmacotherapy for the treatment of fibromyalgia in adults

Review objectives: To assess the efficacy, safety, and tolerability of combination pharmacotherapy compared to monotherapy or placebo, or both, for the treatment of fibromyalgia pain in adults
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Fentanyl for neuropathic pain in adults

Derry S, Stannard C, Cole P, Wiffen PJ, Knaggs R, Aldington D, Moore RA. Fentanyl for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD011605. DOI: 10.1002/14651858.CD011605.pub2

Review objectives: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials
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High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews

Els C, Jackson TD, Hagtvedt R, Kunyk D, Sonnenberg B, Lappi VG, Straube S. High‐dose opioids for chronic non‐cancer pain: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2017, Issue 10. Art. No.: CD012299. DOI: 10.1002/14651858.CD012299.pub2

Review objectives: To describe the evidence from Cochrane Reviews and Overviews regarding the efficacy and safety of high‐dose opioids (here defined as 200 mg morphine equivalent or more per day) for chronic non‐cancer pain
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Hydromorphone for neuropathic pain in adults

Stannard C, Gaskell H, Derry S, Aldington D, Cole P, Cooper TE, Knaggs R, Wiffen PJ, Moore RA. Hydromorphone for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD011604. DOI: 10.1002/14651858.CD011604.pub2

Review objectives: To assess the analgesic efficacy of hydromorphone for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials
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Interventions for the reduction of prescribed opioid use in chronic non-cancer pain

Eccleston C, Fisher E, Thomas KH, Hearn L, Derry S, Stannard C, Knaggs R, Moore RA. Interventions for the reduction of prescribed opioid use in chronic non‐cancer pain. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD010323. DOI: 10.1002/14651858.CD010323.pub3

Review objectives: To investigate the effectiveness of different methods designed to achieve reduction or cessation of prescribed opioid use for the management of chronic non‐cancer pain in adults compared to controls
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Long-term opioid management for chronic noncancer pain

Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM, Chou R. Long‐term opioid management for chronic noncancer pain. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD006605. DOI: 10.1002/14651858.CD006605.pub2

Review objectives: To assess safety, efficacy, and effectiveness of opioids taken long‐term for chronic noncancer pain
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Methadone for chronic non-cancer pain in adults

Haroutounian S, McNicol ED, Lipman AG. Methadone for chronic non‐cancer pain in adults. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD008025. DOI: 10.1002/14651858.CD008025.pub2

Review objectives: To assess the analgesic effectiveness and safety of methadone in the treatment of CNCP
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Methadone for neuropathic pain in adults

McNicol ED, Ferguson MC, Schumann R. Methadone for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No.: CD012499. DOI: 10.1002/14651858.CD012499.pub2

Review objectives: To assess the analgesic efficacy and adverse events of methadone for chronic neuropathic pain in adults
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Morphine for chronic neuropathic pain in adults

Cooper TE, Chen J, Wiffen PJ, Derry S, Carr DB, Aldington D, Cole P, Moore RA. Morphine for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No.: CD011669. DOI: 10.1002/14651858.CD011669.pub2

Review objectives: To assess the analgesic efficacy and adverse events of morphine for chronic neuropathic pain in adults
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Opioids for neuropathic pain

McNicol ED, Midbari A, Eisenberg E. Opioids for neuropathic pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD006146. DOI: 10.1002/14651858.CD006146.pub2

Review objectives: To reassess the efficacy and safety of opioid agonists for the treatment of neuropathic pain
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Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness

Barnes H, McDonald J, Smallwood N, Manser R. Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness. Cochrane Database of Systematic Reviews 2016, Issue 3. Art. No.: CD011008. DOI: 10.1002/14651858.CD011008.pub2

Review objectives: To determine the effectiveness of opioid drugs in relieving the symptom of breathlessness in people with advanced disease due to malignancy, respiratory or cardiovascular disease, or receiving palliative care for any other disease
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Oxycodone for neuropathic pain in adults

Gaskell H, Derry S, Stannard C, Moore RA. Oxycodone for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 7. Art. No.: CD010692. DOI: 10.1002/14651858.CD010692.pub3

Review objectives: To assess the analgesic efficacy and adverse events of oxycodone for chronic neuropathic pain in adults
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Oxycodone for pain in fibromyalgia in adults

Gaskell H, Moore RA, Derry S, Stannard C. Oxycodone for pain in fibromyalgia in adults. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No.: CD012329. DOI: 10.1002/14651858.CD012329

Review objectives: To assess the analgesic efficacy and adverse events of oxycodone for treating pain in fibromyalgia in adults
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Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults

Wiffen PJ, Knaggs R, Derry S, Cole P, Phillips T, Moore RA. Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD012227. DOI: 10.1002/14651858.CD012227.pub2

Review objectives: To assess the analgesic efficacy and adverse events of paracetamol with or without codeine or dihydrocodeine for chronic neuropathic pain in adults
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Tapentadol for chronic musculoskeletal pain in adults

Santos J, Alarcão J, Fareleira F, Vaz Carneiro A, Costa J. Tapentadol for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 5. Art. No.: CD009923. DOI: 10.1002/14651858.CD009923.pub2

Review objectives: To determine the efficacy, safety, and tolerability of tapentadol extended-release for moderate-to-severe pain for at least three months for any musculoskeletal cause
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3. Acute pain

Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain

McNicol ED, Ferguson MC, Hudcova J. Patient controlled opioid analgesia versus non‐patient controlled opioid analgesia for postoperative pain. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD003348. DOI: 10.1002/14651858.CD003348.pub3

Review objectives: To evaluate the efficacy and safety of patient controlled intravenous opioid analgesia (termed PCA in this review) versus non-patient controlled opioid analgesia of as-needed opioid analgesia for postoperative pain relief
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Single dose intra-articular morphine for pain control after knee arthroscopy

Zou Z, An MM, Xie Q, Chen XY, Zhang H, Liu GJ, Shi XY. Single dose intra‐articular morphine for pain control after knee arthroscopy. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD008918. DOI: 10.1002/14651858.CD008918.pub2

Review objectives: To evaluate the relative effects on pain relief and adverse events of IA morphine given for pain control after knee arthroscopy compared with placebo, other analgesics (local anaesthetics, non-steroidal anti-inflammatory drugs (NSAIDs), other opioids) and other routes of morphine administration
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Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews

Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults ‐ an overview of Cochrane reviews. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD008659. DOI: 10.1002/14651858.CD008659.pub3

Review objectives: To summarise the efficacy of pharmaceutical interventions for acute pain in adults with at least moderate pain following surgery who have been given a single dose of oral analgesic
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Single dose oral codeine, as a single agent, for acute postoperative pain in adults

Derry S, Moore RA, McQuay HJ. Single dose oral codeine, as a single agent, for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2010, Issue 4. Art. No.: CD008099. DOI: 10.1002/14651858.CD008099.pub2

Review objectives: To assess the efficacy, the time to onset of analgesia, the time to use of rescue medication and any associated adverse events of single dose oral codeine in acute postoperative pain
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Single dose oral dextropropoxyphene, alone and with paracetamol (acetaminophen), for postoperative pain

Moore RA, Collins SL, Edwards J, Derry S, McQuay HJ. Single dose oral dextropropoxyphene, alone and with paracetamol (acetaminophen), for postoperative pain. Cochrane Database of Systematic Reviews 1999, Issue 1. Art. No.: CD001440. DOI: 10.1002/14651858.CD001440

Review objectives: To determine the analgesic efficacy and adverse effects of single dose oral dextropropoxyphene alone and in combination with paracetamol (acetaminophen) for moderate to severe postoperative pain
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Single dose oral dihydrocodeine for acute postoperative pain

Moore RA, Edwards J, Derry S, McQuay HJ. Single dose oral dihydrocodeine for acute postoperative pain. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002760. DOI: 10.1002/14651858.CD002760

Review objectives: To quantitatively assess the analgesic efficacy and adverse effects of single-dose dihydrocodeine compared with placebo in randomised trials in moderate to severe postoperative pain
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Single dose oral ibuprofen plus codeine for acute postoperative pain in adults

Derry S, Karlin SM, Moore RA. Single dose oral ibuprofen plus codeine for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD010107. DOI: 10.1002/14651858.CD010107.pub3

Review objectives: To assess the analgesic efficacy and adverse effects of a single oral dose of ibuprofen plus codeine for acute moderate-to-severe postoperative pain using methods that permit comparison with other analgesics evaluated in standardised trials using almost identical methods and outcomes
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Single dose oral ibuprofen plus oxycodone for acute postoperative pain in adults

Derry S, Derry CJ, Moore RA. Single dose oral ibuprofen plus oxycodone for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD010289. DOI: 10.1002/14651858.CD010289.pub2

Review objectives: To assess the analgesic efficacy and adverse effects of a single oral dose of ibuprofen plus oxycodone for moderate to severe postoperative pain
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Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults

Gaskell H, Derry S, Moore RA, McQuay HJ. Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD002763. DOI: 10.1002/14651858.CD002763.pub2

Review objectives: To assess efficacy, duration of action, and associated adverse events of single dose oral oxycodone, with or without paracetamol, in acute postoperative pain in adults
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Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults

Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2

Review objectives: Assess efficacy of single dose oral paracetamol plus codeine in acute postoperative pain, increase in efficacy due to the codeine component, and associated adverse events.
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Single fixed-dose oral dexketoprofen plus tramadol for acute postoperative pain in adults

Derry S, Cooper TE, Phillips T. Single fixed‐dose oral dexketoprofen plus tramadol for acute postoperative pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No.: CD012232. DOI: 10.1002/14651858.CD012232.pub2

Review objectives: To assess the analgesic efficacy and adverse effects of a single fixed-dose of oral dexketoprofen plus tramadol, compared with placebo, for moderate to severe postoperative pain in adults, using methods that permit comparison with other analgesics evaluated in standardised trials using almost identical methods and outcomes. A secondary objective was to compare the combination with the individual analgesics alone
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4. Children and adolescents

Opioids for cancer-related pain in children and adolescents

Wiffen PJ, Cooper TE, Anderson AK, Gray AL, Grégoire MC, Ljungman G, Zernikow B. Opioids for cancer‐related pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012564. DOI: 10.1002/14651858.CD012564.pub2

Review objectives: To assess the analgesic efficacy, and adverse events, of opioids used to treat cancer-related pain in children and adolescents aged between birth and 17 years, in any setting
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Opioids for chronic non-cancer pain in children and adolescents

Cooper TE, Fisher E, Gray AL, Krane E, Sethna N, van Tilburg MAL, Zernikow B, Wiffen PJ. Opioids for chronic non‐cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012538. DOI: 10.1002/14651858.CD012538.pub2

Review objectives: To assess the analgesic efficacy and adverse events of opioids used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting
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Nalbuphine for postoperative pain treatment in children

Schnabel A, Reichl SU, Zahn PK, Pogatzki‐Zahn E. Nalbuphine for postoperative pain treatment in children. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD009583. DOI: 10.1002/14651858.CD009583.pub2

Review objectives: To assess the efficacy and adverse events of nalbuphine for acute postoperative pain treatment in children undergoing surgery
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Tramadol for postoperative pain treatment in children

Schnabel A, Reichl SU, Meyer‐Frießem C, Zahn PK, Pogatzki‐Zahn E. Tramadol for postoperative pain treatment in children. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD009574. DOI: 10.1002/14651858.CD009574.pub2

Review objectives: To assess the effectiveness and side effect profile of tramadol for postoperative pain relief in children and adolescents undergoing different surgical procedures
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