The usage rate of rescue analgesia
Eleven studies (26, 29-32, 37, 43-46, 48) compared results for
participants receiving rescue
analgesia between IVIB group and placebo or acetaminophen group. IVIB
(RR, 0.27; 95% CI, 0.15 to 0.47, 11 trials, low certainty) was found to
be associated with a lower usage rate of rescue analgesia compared with
other treatments. However, the further subgroup analysis showed that
there was no significant difference between the IVIB group and the
placebo group (RR, 0.16; 95% CI, 0.02 to 1.29, 9 trials, moderate
certainty), and acetaminophen group (RR, 0.30; 95% CI, 0.06 to 1.35, 6
trials, moderate certainty), respectively (Supplementary Figure 6,
Supplementary Table 7).
Safety
A total of 18 studies (23, 26-29, 31, 32, 34, 35, 42, 43, 45-50, 52)
reported adverse events, mainly including nausea or vomiting, pruritus,
dizziness, headache, flatulence, and dyspepsia. 15 studies (23, 26, 27,
29, 32, 34, 35, 42, 43, 46-48, 50, 52) with 1,746 participants compared
IVIB with placebo. Meta-analysis showed that IVIB was associated with a
lower incidence of nausea or vomiting (RR, 0.71; 95% CI, 0.56 to 0.91,
14 trials, moderate certainty). There was no significant difference in
the incidence of pruritus (RR, 0.94; 95% CI, 0.67 to 1.32, 8 trials,
moderate certainty), dizziness (RR, 0.77; 95% CI, 0.25 to 2.39, 7
trials, moderate certainty), headache (RR, 0.82; 95% CI, 0.43 to 1.58,
4 trials, moderate certainty), dyspepsia (RR, 0.87; 95% CI, 0.33 to
2.32, 4 trials, moderate certainty), or flatulence (RR, 1.08; 95% CI,
0.76 to 1.54, 4 trials, moderate certainty) (Figure 6, Supplementary
Table 7).
Ten studies (26, 29, 31, 35, 39, 42, 43, 45, 46, 49) consisting of 670
participants reported the difference in the safety between IVIB and
acetaminophen. As a result, IVIB was associated with a lower incidence
of nausea or vomiting (RR, 0.65; 95% CI, 0.51 to 0.83, 9 trials,
moderate certainty). There was no significant difference in the
incidence of pruritus (RR, 0.64; 95% CI, 0.22 to 1.84, 3 trials,
moderate certainty) or headache (RR, 0.98; 95% CI, 0.48 to 2.00, 3
trials, moderate certainty) (Supplementary Figure7, Supplementary Table
7).