Study designs of evaluations included in the review
Prospective studies with at least 30 participants which randomly assigned participants to two or more groups were included. No details of the follow-up period were given for the post-operative studies.
Specific interventions included in the review
Analgesics. A wide range of analgesics were evaluated including morphine, diclofenac, ketorolac, lidocaine and a eutectic mixture of local anaesthetics (EMLA). These were evaluated in relation to each other, or against a placebo group.
Participants included in the review
The age of the participants ranged from newborns to 21 years. The school-age child, i.e. 7 to 12 years, was the most frequently studied age group, found in 63% of the studies. This was followed by the pre-schooler, i.e. 4 to 6 years, represented in 56% of the studies. Other studies included adolescents, toddlers, infants, and newborns.
The majority of the 22 studies examined post-operative pain, e.g. pain experienced after orthopedic and abdominal surgery. Nineteen additional studies focused on pain during a variety of procedures, e.g. venipuncture and circumcision.
Outcomes assessed in the review
Procedural and post-operative pain were measured in four different ways:
1. Self report of pain.
2. Observation of pain behaviour.
3. Physiological changes.
4. Analgesic consumption.
Analgesic interventions were used to test:
1. Efficacy of an analgesic.
2. Route of administration.
3. Timing of administration.
4. Dosage of the analgesic.
5. Packaging of the product.
6. Person administering the analgesic.
How were decisions on the relevance of primary studies made?
The author does not state how the papers were selected for the review, or how many of the reviewers performed the selection.