Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment in most of the trials) and upgraded by large magnitude of effect.
A Cochrane review [Abstract] 1 included 12 studies with a total of 828 subjects. When compared with placebo, NSAIDs obtained a significantly lower proportion of participants without complete pain relief (table T1), which was confirmed by Trial Sequential Analysis. NSAIDs showed more pain control than spasmolytic drugs (table T1), which was not confirmed by Trial Sequential Analysis. No difference was found in the proportions of participants without complete pain relief when comparing NSAIDs versus opioids (table T1). None of the included trials reported severe adverse events. Seven trials assessed non-severe adverse events: in 2, adverse events were not observed, and minor events were reported in the remaining 5 trials. There was no mortality.
| Outcome | Relative effect(95% CI) | Risk with control | Risk with intervention - NSAIDs (95% CI) | No of Participants(studies) Quality of evidence |
|---|---|---|---|---|
| Lack of pain relief | RR 0.27 (0.19 to 0.4) | Placebo 784 / 1000 | 212 / 1000(149 to 314) | 208(5) Moderate |
| Cholelithiasis-related complications | RR 0.66 (0.38 to 1.15) | 471 / 1000 | 311 / 1000(179 to 541) | 140(3) Very low |
| Lack of pain relief | RR 0.98 (0.47 to 2.07) | Opioids 180 / 1000 | 176 / 1000(84 to 372) | 459(4) Very low |
| Cholelithiasis-related complications | RR 0.88 (0.14 to 5.42) | 143 / 1000 | 126 / 1000(20 to 774) | 30(1) Very low |
| Lack of pain relief | RR 0.51 (0.37 to 0.71) | Spasmolytics 598 / 1000 | 305 / 1000(221 to 424) | 190(4) Low |
| Cholelithiasis-related complications | RR 0.27 (0.12 to 0.57) | 462 / 1000 | 125 / 1000(55 to 263) | 104(2) Low |
Date of latest search: 15 July 2016
Primary/Secondary Keywords