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Review: intravenous and oral opioids reduce chronic non-cancer pain but are associated with high rates of constipation, nausea, and sleepiness

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Q Are opioids effective and safe for reducing chronic non-cancer pain?

METHODS

Embedded ImageData sources:

Medline (1966 to September 2003), EMBASE/Excerpta Medica (1980 to September 2003), Cochrane Library (September 2003), Oxford Pain Relief Database (1950–94); and hand searches of reference lists.

Embedded ImageStudy selection and assessment:

double blind, randomised controlled trials (RCTs) in any language that compared oral, transdermal, or intravenous (IV) World Health Organisation (WHO) step 3 opioids with placebo; included >10 adults/group; and reported pain intensity outcomes assessed using a visual analogue scale, a 0–10 numerical rating scale, or a 4 point categorical scale. Study quality was assessed using the 3 item Jadad scale and a 5 item validity scale.

Embedded ImageOutcomes:

pain intensity or pain relief. Secondary outcomes were mood, functional status, quality of life (QOL), and adverse …

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