› In a review of 6 randomized, double-blind clinical trials involving 1342 participants,
Cochrane investigators reported that a single dose of oral ibuprofen (400 mg) plus codeine
(25.6–60 mg) was effective in controlling postoperative pain in adults, and that limiteddata suggests that the combination analgesic may be more effective than the same dose of
either drug alone (Derry et al., 2013)
› Many clinicians hesitate to prescribe opioids for management of postoperative pain in patients with cognitive impairment
because of concerns that doing so may cause delirium; researchers who conducted a recent study of 236 patients aged 65
and older undergoing surgery for hip fracture found no association between opioid use and postoperative delirium in patients
with and without dementia (Sieber et al., 2011)
› Although use of aspirin for pain management has declined in developed countries because of its gastrointestinal adverse
effects, it is inexpensive and widely available and remains a commonly used analgesic; authors of a recent Cochrane review
found evidence that single doses of 600–650 mg aspirin produce good levels of pain relieve in ~ 40% of postoperative
patients with moderate to severe pain (Derry et al., 2012)