Acetaminophen (paracetamol) is no better than placebo for most pain, except maybe tension headache

Référence

Saragiotto BT, Shaheed CA, Maher CG. Paracetamol for pain in adults. BMJ 2019;367:l6693.

Sommaire

These authors searched 3 databases, including the Cochrane Library, to identify systematic reviews of randomized controlled trials of acetaminophen compared with placebo for pain relief in adults. They also searched clinical guidelines and reference lists of studies. Since they were presenting the results of other systematic reviews, they relied on those reviews for assessment of the original research. Based on a Cochrane review of 8 studies of 5890 patients, acetaminophen is effective for the treatment of episodic tension-type headache, though the effect is small (number needed to treat [NNT] = 22), which is misleading because of a high response to placebo (high-quality evidence). It is also effective, though based on low quality evidence, for complete pain relief of acute migraine (NNT = 12) and some pain relief at 2 hours (NNT = 5). A single dose is twice as likely as placebo to decrease perineal pain postpartum and some patients with renal colic will experience relief (one trial). It has not been shown to be effective for patients with acute low back pain or pain due to knee or hip osteoarthritis.