Evid Based Nurs 8:88 doi:10.1136/ebn.8.3.88
  • Treatment

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

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


GraphicData 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.

GraphicStudy 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.


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


15 RCTs met the selection criteria. Mean study quality score was 4 out of 5, and mean validity score …

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