Evidence map›Paper›PMID 41739420›Full record

SynthesisDrugs2026

Efficacy and Harms of Opioid Analgesics for Acute Pain: Overview of Systematic Reviews and Meta-analyses.

Stephanie Mathieson, Joshua R Zadro, Sujita W Narayan, Andrew J McLachlan, Jane C Ballantyne, Fiona M Blyth, Richard O Day, Christopher G Maher, Hanan McLachlan, Chung-Wei Christine Lin and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Stephanie Mathieson *Sydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0002-7335-8842
Joshua R Zadro *Sydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0001-8981-2125
Sujita W NarayanInstitute for Musculoskeletal Health, Royal Prince Alfred Hospital (C39), Sydney Local Health District, Level 10N, King George V Building, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0001-8706-2113
Andrew J McLachlanSydney School of Pharmacy, University of Sydney, A15, Science Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0003-4674-0242
Jane C BallantyneUniversity of Washington Medical Centre, University of Washington, 1959 NE Pacific Street, Seattle, Washington, USA.ORCID http://orcid.org/0000-0003-0741-9771
Fiona M BlythSydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0003-1128-6756
Richard O DaySt Vincent's Clinical Campus, School of Medicine, St Vincent's Hospital, University of New South Wales, Level 5, de Lacy Building, Darlinghurst, NSW, 2010, Australia.ORCID http://orcid.org/0000-0002-6045-6937
Christopher G MaherSydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0002-1628-7857
Hanan McLachlanSydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0009-0003-0895-3922
Chung-Wei Christine LinSydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0001-6192-7238
Steven J KamperSydney School of Health Sciences, University of Sydney, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia.ORCID http://orcid.org/0000-0003-3012-5499
Christina Abdel ShaheedSydney School of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW, 2050, Australia. christina.abdelshaheed@sydney.edu.au.ORCID http://orcid.org/0000-0003-1258-5125

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioids are commonly prescribed for acute pain. However, there is no overarching synthesis on their efficacy.

aimWe set out to conduct an overview review of the efficacy and harms of opioid analgesics for acute pain.

methodsElectronic databases were searched until 4 March 2025 without restriction for systematic reviews of randomised trials comparing opioids to placebo/no active treatment for any acute, non-malignant pain condition published since 2010. Screening, extraction and quality assessment were conducted independently by two authors. The primary outcome was pain. Secondary outcomes were adverse events. Data timepoints were immediate (≤ 3 h after administration-primary timepoint), short (> 3 to ≤ 6 h), intermediate (> 6 to ≤ 48 h) and long term (> 48 h). Random effect meta-analyses were conducted. AMSTAR 2 described review quality. Grading of Recommendations Assessment, Development and Evaluation determined evidence certainty.

resultsWe included 59 reviews. There was high certainty some opioids (morphine, oxycodone, tramadol, papaveretum) reduced acute abdominal pain at immediate term (mean difference [MD] - 18.4, 95% CI - 31.9 to - 5.0) compared with placebo. However, there were no harms data. At immediate term, there was moderate certainty opioids reduced pain including dental surgery (MD - 19.5, 95% CI - 25.0 to - 14.0), and myringotomy (MD - 15.0, 95% CI - 19.6 to - 10.4). However, harms data were only available for dental surgery, finding no increased risk of adverse events. Oral opioids provided only very small pain relief for acute musculoskeletal pain at intermediate term (MD - 8.9, 95% CI - 13.5 to - 4.3; moderate certainty) but increased the risk of adverse events (risk difference [RD] 0.1, 95% CI 0.0 to 0.2; moderate certainty). LIMITATIONS: Some opioids are not consistently efficacious across timepoints.

conclusionsOpioid analgesics are efficacious in reducing pain in some acute conditions. REGISTRATION: ROSPERO CRD42018109733.

Indexed as

Acute PainAnalgesics, OpioidHumansMeta-Analysis as TopicRandomized Controlled Trials as TopicSystematic Reviews as TopicAnalgesics, Opioid

Identifiers

PMID41739420
PMCPMC13005847

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.