Evidence Favors NSAIDs For Pediatric Acute Pain

A meta-analysis of 41 randomized clinical trials found that nonsteroidal anti-inflammatory drugs (NSAIDs) were as effective as ketamine and high-potency opioids for treating pediatric acute pain, while having fewer risks (N=4,935; median age 9.7 years). Researchers found all 3 drug categories outperformed placebo in treating that pain with at least moderate certainty. In the study, presented in JAMA Pediatrics, the reduction in pain severity was “modest” overall. Only NSAIDs reduced the need for rescue medication (RR 0.31, 95% CI 0.14-0.68) and did not increase short-term gastrointestinal adverse events (RR 0.69, 95% CI 0.31-1.55). Opioid use remains common despite inconsistent evidence of superior benefit, therefore, NSAIDs may offer a safer, effective alternative, according to the authors. Interventions compared in the research included: placebo; acetaminophen; NSAIDs; tramadol; codeine; mid- to high-potency opioids; ketamine; or a combination of these. 

New options still too new: In recent days, the Food and Drug Administration approved a new, first-in-class, non-opioid analgesic called suzetrigine to treat moderate to severe acute pain in adults. However, it could be years before research might determine the potential appropriateness of this new class of pain of drugs for children.

Read More

• New Non-opioid Analgesic Suzetrigine Set to Launch for Treatment of Acute Pain
• Evaluation and Management of Pain (Part 1): Acute Pain