Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
Over-the-counter analgesics effective for acute postoperative pain
Vault Navigation
Over-the-counter analgesics effective for acute postoperative pain
How effective are single doses of non-prescription (over-the-counter or OTC) oral analgesics for acute postoperative pain? Successful treatment was defined as at least 50% of maximum possible pain relief, over a period of about 6 hours.
Combinations of ibuprofen plus paracetamol provided pain relief worked in 70% of people (NNT* 2), and fast acting ibuprofen formulations 200mg and 400mg, ibuprofen 200mg plus caffeine 100mg, and diclofenac potassium 50mg worked in over 50% of people (NNT close to 2). Dipyrone 500mg, which is available OTC in many parts of the world, also worked in about 50% of people. Paracetamol plus aspirin at various doses worked in 11% to 43% of people (NNT 3 or above). An important finding was that low doses of some medicines in fast acting formulations were among the best. Taking painkillers with food might reduce how well they work. There were fewer side effects for people taking ibuprofen plus paracetamol than those taking placebo. The quality of the evidence was good. *NNT = number needed to treat to benefit one individual.
There was no information on many of the commonly available combinations containing low doses of codeine. The results for side effects might be different if the painkillers were taken for more than a few days.
OTC analgesics are used frequently. They are available in various brands, package sizes, formulations and dose. They can be used for a range of different types of pain, but this overview reports on how well they work for acute postoperative pain.
Moore RA et al. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Reviews, 2015, Issue 11. Art. No.: CD010794.DOI: 10.1002/14651858. CD010794.pub2. This review contains information from 39 Cochrane Reviews involving 41 different OTC drugs.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz