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Evidence summaries

Single Dose Oral Aspirin for Acute Pain

Aspirin is an effective analgesic for acute pain of moderate to severe intensity with a clear dose-response. Drowsiness and gastric irritation are seen as significant adverse effects even though the studies were single-dose. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 67 studies with a total of 5 743 subjects. Significant benefit of aspirin over placebo was shown for aspirin 600/650 mg, 900/1 000 mg and 1 200 mg, NNTs for at least 50% pain relief over 4 to 6 hours were 4.2 (3.9 to 4.8), 3.8 (3.0 to 5.1) and 2.7 (2.0 to 3.8), respectively. Fewer participants required rescue medication with aspirin than with placebo over 4 to 8 hours postdose, but by 12 hours there was no difference.

The number of participants experiencing adverse events was not significantly different from placebo for 600/650 mg aspirin, but for 900/1000 mg the number needed to treat to harm was 7.5 (4.8 to 17). The most commonly reported events were dizziness, drowsiness, gastric irritation, nausea, and vomiting, nearly all of which were of mild to moderate severity.

    References

    • Derry S, Moore RA. Single dose oral aspirin for acute postoperative pain in adults. Cochrane Database Syst Rev 2012;(4):CD002067. [PubMed]

Primary/Secondary Keywords