Summary of findings 2. NSAID (single administration, any dose) compared to paracetamol for perineal pain in the early postpartum period.
| NSAID (single administration, any dose) compared to paracetamol for perineal pain in the early postpartum period | ||||||
| Patient or population: women with perineal pain in the early postpartum period Setting: maternity hospitals in Italy, Spain, USA, France and Thailand Intervention: NSAID (single administration, any dose) Comparison: paracetamol | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with paracetamol | Risk with NSAID (single administration, any dose) | |||||
| Adequate pain relief (4 hours after administration) | Study population | RR 1.54 (1.07 to 2.22) | 342 (3 RCTs) | ⊕⊕⊝⊝ lowa,b | ‐ | |
| 205 per 1000 | 315 per 1000 (219 to 454) | |||||
| Adequate pain relief (6 hours after administration) | Study population | RR 1.82 (0.61 to 5.47) | 99 (2 RCTs) | ⊕⊝⊝⊝ very lowa,c | ‐ | |
| 200 per 1000 | 364 per 1000 (122 to 1000) | |||||
| Need for additional analgesia (4 hours after administration) | Study population | RR 0.55 (0.27 to 1.13) | 73 (1 RCT) | ⊕⊝⊝⊝ very lowa,c | ‐ | |
| 405 per 1000 | 223 per 1000 (109 to 458) | |||||
| Need for additional analgesia (6 hours after administration) | Study population | RR 0.28 (0.12 to 0.67) | 59 (1 RCT) | ⊕⊕⊝⊝ lowa,b | ‐ | |
| 571 per 1000 | 160 per 1000 (69 to 383) | |||||
| Maternal drug adverse effects (4 hours after administration) | See comment | not estimable | 210 (1 RCT) | 1 study (210 women) reported no maternal drug adverse events in either the intervention or control group | ||
| Maternal drug adverse effects (6 hours after administration) | Study population | RR 0.74 (0.27 to 2.08) | 300 (3 RCTs) | ⊕⊝⊝⊝ very lowa,c | ‐ | |
| 53 per 1000 | 39 per 1000 (14 to 111) | |||||
| Neonatal drug adverse effects ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐‐ | ‐ |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
aDowngraded one level for serious risk of bias: unclear risk of selection bias. bDowngraded one level for imprecision: few participants. cDowngraded two levels for imprecision: few participants and wide 95% confidence interval consistent with possible benefit and possible harm.