NSAIDs Found Most Effective in Treating Acute Pain in Children: JAMA

A recent clinical review published in the Journal of American Medical Association evaluated the comparative effectiveness and safety of various pharmacologic treatments for acute pain in children. The findings revealed the superiority of nonsteroidal anti-inflammatory drugs (NSAIDs) over other analgesic options in reducing pain while maintaining a favorable safety profile.

The study assessed 41 randomized clinical trials involved a total 4,935 pediatric patients under the age of 18. The analysis found that NSAIDs, ketamine, and mid- to high-potency opioids demonstrated significant pain-relief benefits when compared with placebo. Also, NSAIDs showed the highest pain reduction, with a weighted mean difference (WMD) of -1.29 on a 10 cm visual analog scale. Ketamine and mid- to high-potency opioids followed closely with reductions of -1.12 and -1.19, respectively.

However, NSAIDs stood out as the only pharmacologic option to significantly reduce the need for additional rescue medication, with a relative risk reduction of 69%. This means that patients using NSAIDs were 16% less likely to require additional pain relief.

Also, NSAIDs did not pose an increased risk of short-term gastrointestinal side effects which is a concern often associated with this class of drugs. Acetaminophen also showed no significant increase in adverse events. The study highlighted moderate-certainty data which suggests that other treatments demonstrated little to no significant benefit over placebo or were supported by lower certainty evidence.