Cochrane Clinical Answers - Fulltext - How does single dose oral acetaminophen plus codeine affect outcomes in adults with postoperative pain?

Question:How does single dose oral acetaminophen plus codeine affect outcomes in adults with postoperative pain?

Clinical Answer:

Single dose acetaminophen (300 mg-1000 mg) plus codeine (30 mg-60 mg) leads to at least a 50% reduction in pain and decreased use of rescue medications at 4-6 hours postop compared with placebo or equivalent doses of acetaminophen alone with no statistically significant difference in adverse events. The most commonly assessed dose (studies including around 1,500 people) was acetaminophen 600 to 650 mg plus codeine 60 mg.

The studies assessing were rated 4 or 5 on the 5 point Jadad quality scale, had adequate randomization and blinding procedures and reported reasons for patient withdrawal.

Full outcome data is detailed below:

1.Acetaminophen (paracetamol) 800 to 1000 mg plus codeine 60 mg versus placebo

  • Population, Intervention, Comparator

    Population:

    Adolescents and adults (aged 15 years and over) undergoing dental surgery, cesarean section, or orthopedic surgery (not further defined)

    Intervention:

    Single dose acetaminophen 800 mg (1 study) or 1000 mg (2 studies) plus codeine 60 mg

    Comparator:

    Single dose placebo

  • OUTCOME 1.1: Participants with at least 50% pain relief over 4 to 6 hours

    Risk of bias of studies:

    The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

    Narrative result:

    Three RCTs with 192 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours compared with placebo. There was moderate statistical heterogeneity in this analysis (I2=60%); the authors did not perform subgroup analyses assessing dental and other surgery separately.

    Relative effect or mean difference:

    There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 6.34, 95% CI 2.93 to 13.73).

    Forest plot from Cochrane Review

    Absolute effect:

    19 per 100 people (95% CI 9 to 42) with acetaminophen plus codeine compared with 3 per 100 people with placebo.

    Reference:
    Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
    • OUTCOME 1.2: Participants with any adverse event

      Risk of bias of studies:

      The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

      Narrative result:

      Three RCTs with 209 participants found no statistically significant difference between groups.

      Relative effect or mean difference:

      There was no statistically significant difference between groups (RR 0.89, 95% CI 0.58 to 1.39).

      Forest plot from Cochrane Review

      Absolute effect:

      There was no statistically significant difference between groups.

      Reference:
      Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

      2.Acetaminophen 800 to 1000 mg plus codeine 60 mg versus acetaminophen 1000 mg

      • Population, Intervention, Comparator

        Population:

        Adolescents and adults (aged 15 years and over) undergoing dental surgery, cesarean section, elective general or orthopedic surgery (not further defined)

        Intervention:

        Single dose acetaminophen 800 mg (1 study) or 1000 mg (3 studies) plus codeine 60 mg

        Comparator:

        Single dose acetaminophen 800 mg (1 study) or 1000 mg (3 studies)

      • OUTCOME 2.1: Participants with at least 50% pain relief over 4 to 6 hours

        Risk of bias of studies:

        The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

        Narrative result:

        Four RCTs with 304 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours compared with acetaminophen alone. There was no statistical heterogeneity in this analysis and the authors did not perform subgroup analyses assessing dental and other surgery separately.

        Relative effect or mean difference:

        There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 1.31, 95% CI 1.06 to 1.62).

        Forest plot from Cochrane Review

        Absolute effect:

        61 per 100 people (95% CI 49 to 75) with acetaminophen plus codeine compared with 46 per 100 people with acetaminophen alone.

        Reference:
        Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
        • OUTCOME 2.2: Participants using rescue medication over 4 to 6 hours

          Risk of bias of studies:

          The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

          Narrative result:

          Two RCTs with 127 participants found that acetaminophen plus codeine reduced participants using rescue medication over 4 to 6 hours compared with acetaminophen alone.

          Relative effect or mean difference:

          There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 0.61, 95% CI 0.41 to 0.89).

          Forest plot from Cochrane Review

          Absolute effect:

          41 per 100 people (95% CI 28 to 61) with acetaminophen plus codeine compared with 68 per 100 people with acetaminophen alone.

          Reference:
          Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
          • OUTCOME 2.3: Participants with any adverse event

            Risk of bias of studies:

            The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

            Narrative result:

            Four RCTs with 324 participants found no statistically significant difference between groups.

            Relative effect or mean difference:

            There was no statistically significant difference between groups (OR 1.13, 95% CI 0.70 to 1.81).

            Forest plot from Cochrane Review

            Absolute effect:

            There was no statistically significant difference between groups.

            Reference:
            Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

            3.Acetaminophen 600 to 650 mg plus codeine 60 mg versus placebo

            • Population, Intervention, Comparator

              Population:

              Adolescents and adults (aged 15 years and over) undergoing dental (most studies), general, gynecological or orthopedic surgery (not further defined)

              Intervention:

              Single dose acetaminophen 600 mg (most studies) or 650 mg plus codeine 60 mg

              Comparator:

              Single dose placebo

            • OUTCOME 3.1: Participants with at least 50% pain relief over 4 to 6 hours

              Risk of bias of studies:

              The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

              Narrative result:

              17 RCTs with 1413 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours compared with placebo. Subgroup analyses assessing dental and other postoperative pain separately found similar results to the main analysis.

              Relative effect or mean difference:

              There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 2.64, 95% CI 2.17 to 3.21).

              Forest plot from Cochrane Review

              Absolute effect:

              51 per 100 people (95% CI 42 to 62) with acetaminophen plus codeine compared with 19 per 100 people with placebo.

              Reference:
              Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
              • OUTCOME 3.2: Participants using rescue medication over 4 to 6 hours

                Risk of bias of studies:

                The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                Narrative result:

                Ten RCTs with 657 participants found that acetaminophen plus codeine reduced the proportion of participants using rescue medication over 4 to 6 hours compared with placebo.

                Relative effect or mean difference:

                There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 0.75, 95% CI 0.68 to 0.82).

                Forest plot from Cochrane Review

                Absolute effect:

                63 per 100 people (95% CI 57 to 69) with acetaminophen plus codeine compared with 84 per 100 people with placebo.

                Reference:
                Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                • OUTCOME 3.3: Participants with any adverse event

                  Risk of bias of studies:

                  The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                  Narrative result:

                  14 RCTs with 1258 participants found that acetaminophen plus codeine increased the proportion of participants with any adverse event compared with placebo.

                  Relative effect or mean difference:

                  There was a statistically significant difference between groups, in favor of placebo (RR 1.57, 95% CI 1.27 to 1.93).

                  Forest plot from Cochrane Review

                  Absolute effect:

                  31 per 100 people (95% CI 25 to 39) with acetaminophen plus codeine compared with 20 per 100 people with placebo.

                  Reference:
                  Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

                  4.Acetaminophen 600 to 650 mg plus codeine 60 mg versus acetaminophen 600-650 mg

                  • Population, Intervention, Comparator

                    Population:

                    Adolescents and adults (aged 15 years and over) undergoing dental (most studies), general, gynecological or orthopedic surgery (not further defined)

                    Intervention:

                    Single dose acetaminophen 600 mg (most studies) or 650 mg plus codeine 60 mg

                    Comparator:

                    Single dose acetaminophen 600 mg (most studies) or 650 mg

                  • OUTCOME 4.1: Participants with at least 50% pain relief over 4 to 6 hours

                    Risk of bias of studies:

                    The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                    Narrative result:

                    Ten RCTs with 622 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours compared with acetaminophen alone. Subgroup analyses assessing dental and other postoperative pain separately found that there was no statistically significant difference between groups undergoing other surgery but this may have been due to lack of power in this analysis. Click below for full details.

                    Relative effect or mean difference:

                    There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 1.30, 95% CI 1.11 to 1.52).

                    Forest plot from Cochrane Review

                    Absolute effect:

                    51 per 100 people (95% CI 43 to 60) with acetaminophen plus codeine compared with 39 per 100 people with acetaminophen alone

                    Reference:
                    Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                    • Subgroup analysis 4.1.1: Participants with at least 50% pain relief over 4 to 6 hours, dental
                      Risk of bias of studies:

                      The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                      Narrative result:

                      Eight RCTs with 512 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours, dental compared with acetaminophen alone

                      Relative effect or mean difference:

                      There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 1.32, 95% CI 1.11 to 1.57).

                      Forest plot from Cochrane Review

                      Absolute effect:

                      44 per 100 people (95% CI 37 to 52) with acetaminophen plus codeine compared with 33 per 100 people with acetaminophen alone

                      Reference:
                      Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                    • Subgroup analysis 4.1.2: Participants with at least 50% pain relief over 4 to 6 hours, other surgery
                      Risk of bias of studies:

                      The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                      Narrative result:

                      Two RCTs with 110 participants found no statistically significant difference between groups. The analysis may have lacked power to detect a clinically important difference.

                      Relative effect or mean difference:

                      There was no statistically significant difference between groups (RR 1.21, 95% CI 0.83 to 1.77).

                      Forest plot from Cochrane Review

                      Absolute effect:

                      There was no statistically significant difference between groups.

                      Reference:
                      Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                  • OUTCOME 4.2: Participants using rescue medication over 4 to 6 hours

                    Risk of bias of studies:

                    The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                    Narrative result:

                    Seven RCTs with 436 participants found that acetaminophen plus codeine reduced the proportion of participants using rescue medication over 4 to 6 hours compared with acetaminophen alone

                    Relative effect or mean difference:

                    There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 0.75, 95% CI 0.64 to 0.88).

                    Forest plot from Cochrane Review

                    Absolute effect:

                    55 per 100 people (95% CI 47 to 64) with acetaminophen plus codeine compared with 73 per 100 people with acetaminophen alone.

                    Reference:
                    Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                    • OUTCOME 4.3: Participants with any adverse event

                      Risk of bias of studies:

                      The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                      Narrative result:

                      Seven RCTs with 443 participants found no statistically significant difference between groups.

                      Relative effect or mean difference:

                      There was no statistically significant difference between groups (RR 1.11, 95% CI 0.79 to 1.57).

                      Forest plot from Cochrane Review

                      Absolute effect:

                      There was no statistically significant difference between groups.

                      Reference:
                      Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

                      5.Acetaminophen 300 mg plus codeine 30 mg versus placebo

                      • Population, Intervention, Comparator

                        Population:

                        Adolescents and adults (aged 15 years and over) undergoing dental or orthopedic surgery (not further defined)

                        Intervention:

                        Single dose acetaminophen 300 mg plus codeine 30 mg

                        Comparator:

                        Single dose placebo

                      • OUTCOME 5.1: Participants with at least 50% pain relief over 4 to 6 hours

                        Risk of bias of studies:

                        The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                        Narrative result:

                        Six RCTs with 690 participants found that acetaminophen plus codeine increased the proportion of participants with at least 50% pain relief over 4 to 6 hours compared with placebo. Subgroup analyses assessing dental and other postoperative pain separately found that there was a greater effect size in patients undergoing dental surgery. Click below for full details.

                        Relative effect or mean difference:

                        There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 1.87, 95% CI 1.42 to 2.47).

                        Forest plot from Cochrane Review

                        Absolute effect:

                        32 per 100 people (95% CI 24 to 42) with acetaminophen plus codeine compared with 17 per 100 people with placebo.

                        Reference:
                        Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                        • OUTCOME 5.2: Participants with at least 50% pain relief over 4 to 6 hours, dental

                          Risk of bias of studies:

                          The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                          Narrative result:

                          Three RCTs with 299 participants found that acetaminophen plus codeine increased participants with at least 50% pain relief over 4 to 6 hours, dental compared with placebo.

                          Relative effect or mean difference:

                          There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 3.31, 95% CI 1.76 to 6.23).

                          Forest plot from Cochrane Review

                          Absolute effect:

                          22 per 100 people (95% CI 12 to 42) with acetaminophen plus codeine compared with 7 per 100 people with placebo.

                          Reference:
                          Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                          • OUTCOME 5.3: Participants with at least 50% pain relief over 4 to 6 hours, other surgery

                            Risk of bias of studies:

                            The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                            Narrative result:

                            Three RCTs with 391 participants found that acetaminophen plus codeine increased participants with at least 50% pain relief over 4 to 6 hours, other surgery compared with placebo.

                            Relative effect or mean difference:

                            There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 1.51, 95% CI 1.11 to 2.05).

                            Forest plot from Cochrane Review

                            Absolute effect:

                            42 per 100 people (95% CI 31 to 56) with acetaminophen plus codeine compared with 28 per 100 people with placebo.

                            Reference:
                            Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                            • OUTCOME 5.4: Participants using rescue medication over 4 to 6 hours

                              Risk of bias of studies:

                              The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                              Narrative result:

                              Four RCTs with 529 participants found that acetaminophen plus codeine reduced participants using rescue medication over 4 to 6 hours compared with placebo.

                              Relative effect or mean difference:

                              There was a statistically significant difference between groups, in favor of acetaminophen plus codeine (RR 0.79, 95% CI 0.68 to 0.91).

                              Forest plot from Cochrane Review

                              Absolute effect:

                              31 per 100 people (95% CI 27 to 36) with acetaminophen plus codeine compared with 40 per 100 people with placebo.

                              Reference:
                              Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]
                              • OUTCOME 5.5: Participants with any adverse event

                                Risk of bias of studies:

                                The reviewers did not perform a GRADE assessment of the quality of the evidence. They assessed studies using the Jadad 5-point quality scale and most studies were rated as 4 or 5 having adequate randomization and blinding procedures and reporting on reasons for patient withdrawal from the study.

                                Narrative result:

                                Three RCTs with 344 participants found no statistically significant difference between groups.

                                Relative effect or mean difference:

                                There was no statistically significant difference between groups (RR 0.85, 95% CI 0.50 to 1.45).

                                Forest plot from Cochrane Review

                                Absolute effect:

                                There was no statistically significant difference between groups.

                                Reference:
                                Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

                                Additional Information:

                                DOI

                                10.1002/cca.1389

                                Publication Dates

                                1. Published Online: 1 SEP 2016

                                CCA derived from

                                Toms L, Derry S, Moore RA, McQuay HJ. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD001547. DOI: 10.1002/14651858.CD001547.pub2. [Review search date: October 2008]

                                How to Cite

                                How does single dose oral acetaminophen plus codeine affect outcomes in adults with postoperative pain? Christopher Bunt (MD) (on behalf of Cochrane Clinical Answers Editors). Cochrane Clinical Answers 2012. DOI: 10.1002/cca.1389.

                                Further Information

                                • CCA Associate editor: Christopher Bunt (MD), Associate Professor of Family Medicine, Uniformed Services University, Bethesda, MD, USA.
                                • CCA Editor: Karen Pettersen. Correspondence to kpettersen@wiley.com.