Evidence map›Paper›PMID 28027389›Full record

SynthesisThe Cochrane database of systematic reviews2016

Paracetamol (acetaminophen) with or without codeine or dihydrocodeine for neuropathic pain in adults.

Philip J Wiffen, Roger Knaggs, Sheena Derry, Peter Cole, Tudor Phillips, R Andrew Moore

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 56 citations in OpenAlex.

  1. Pooled it
  2. Pregabalin for neuropathic pain in adults.The Cochrane database of systematic reviews · 2019
    Pooled it
  3. Pooled it
  4. Gabapentin for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  5. Morphine for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  6. Article
  7. The analgesic paracetamol metabolite AM404 acts peripherally to directly inhibit sodium channels.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
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  12. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Philip J WiffenPain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
Roger KnaggsSchool of Pharmacy, University of Nottingham, University Park, Nottingham, UK, NG7 2RD.
Sheena DerryPain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
Peter ColeOxford Pain Relief Unit, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road Headington, Oxford, UK, OX3 7LE.
Tudor PhillipsPain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
R Andrew MoorePain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
Churchill Hospital · GBNuffield Orthopaedic Centre · GBNuffield Health · GBUniversity of Nottingham · GB

Funding

Department of Health 13/89/29
6 · The paper itself

Abstract

backgroundParacetamol, either alone or in combination with codeine or dihydrocodeine, is commonly used to treat chronic neuropathic pain. This review sought evidence for efficacy and harm from randomised double-blind studies.

objectivesTo assess the analgesic efficacy and adverse events of paracetamol with or without codeine or dihydrocodeine for chronic neuropathic pain in adults. SEARCH

methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase from inception to July 2016, together with reference lists of retrieved papers and reviews, and two online study registries. SELECTION CRITERIA: We included randomised, double-blind studies of two weeks' duration or longer, comparing paracetamol, alone or in combination with codeine or dihydrocodeine, with placebo or another active treatment in chronic neuropathic pain. DATA COLLECTION AND ANALYSIS: Two review authors independently searched for studies, extracted efficacy and adverse event data, and examined issues of study quality and potential bias. We did not carry out any pooled analyses. We assessed the quality of the evidence using GRADE. MAIN

resultsNo study satisfied the inclusion criteria. Effects of interventions were not assessed as there were no included studies. We have only very low quality evidence and have no reliable indication of the likely effect. AUTHORS'

conclusionsThere is insufficient evidence to support or refute the suggestion that paracetamol alone, or in combination with codeine or dihydrocodeine, works in any neuropathic pain condition.

Indexed as

AcetaminophenAdultAnalgesics, Non-NarcoticAnalgesics, OpioidChronic PainCodeineHumansNeuralgiaAcetaminophenAnalgesics, Non-NarcoticAnalgesics, OpioidCodeinedihydrocodeine

Identifiers

PMID28027389
PMCPMC6463878
OpenAlexW2566232834

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.