Opioids for Acute Musculoskeletal Pain: A Systematic Review with Meta-Analysis

To evaluate the efficacy of opioids for people with acute musculoskeletal pain against placebo. Systematic review and meta-analyses of randomised, placebo-controlled trials of opioid analgesics for acute musculoskeletal pain in any setting. The primary outcomes were pain and disability at the immediate timepoint (< 24 h). Multiple databases were searched from their inception to February 22nd, 2023. Continuous outcomes were converted to a 0–100 scale. Dichotomous outcomes were presented as risk differences. Risk of bias and certainty of evidence was assessed. We located 17 trials (1 intravenous and 16 oral route of administration). For adults, high certainty evidence from 11 comparisons shows that oral opioids provide small benefits relative to placebo in the immediate term for pain (mean difference [MD] − 8.8 95