Comparison of the postoperative analgesic effects of naproxen sodium and naproxen sodium-codeine phosphate for arthroscopic meniscus surgery

Bali, Çağla; Ergenoğlu, Pınar; Özmete, Özlem; Akın, Şule; Özyılkan, Nesrin Bozdoğan; Çok, Oya Yalçın; Ariboğan, Anış

doi:10.1016/j.bjane.2014.08.006

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…Eight studies evaluated the efficacy of pre‐emptive nonopioid pain medications (Table 2) [4, 13, 25, 28, 30, 35, 46, 47]. Seven studies examining preoperative analgesia had placebo groups and were included in the quantitative syntheses.…”

Section: Resultsmentioning

confidence: 99%

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Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis

Gazendam

Ekhtiari

Horner

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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PurposeThe opioid epidemic has prompted an emphasis on investigating opioid‐sparing alternatives for pain management following knee arthroscopy. This review evaluated the effects of perioperative nonopioid adjunct analgesia on postoperative opioid consumption and pain control in patients undergoing knee arthroscopy. MethodsA systematic review and meta‐analysis was performed using the following databases: PubMed, Embase, Web of Science, MEDLINE, and SCOPUS. Prospective comparative studies assessing the efficacy of various perioperative nonopioid analgesic strategies in patients undergoing knee arthroscopy were included. Twenty‐five studies (n = 2408) were included. ResultsPre‐emptive nonopioid pain medications demonstrated a reduction in cumulative postoperative oral morphine equivalent (OME) consumption by 11.8 mg (95% CI − 18.3, − 5.4, p ≤ 0.0001) and VAS pain scores by 1.5 (95% CI − 2.3, − 0.7, p < 0.001) at 24 h compared to placebo. Postoperative nonopioid pain medications significantly reduced cumulative postoperative OME consumption by 9.7 mg (95% CI − 14.4, − 5.1, p < 0.001) and VAS pain scores by 1.0 (95% CI − 1.354, − 0.633, p < 0.001) at 24 h compared to placebo. Saphenous nerve blocks significantly reduced cumulative postoperative OME consumption by 6.5 mg (95% CI − 10.3, − 2.6, p = 0.01) and VAS pain scores by 0.8 (− 1.4, − 0.3, p = 0.03) at 24 h compared to placebo. Both preoperative patient education and postoperative cryotherapy reduced postoperative opioid consumption. ConclusionPerioperative nonopioid pharmacotherapy, saphenous nerve blocks, and cryotherapy for patients undergoing knee arthroscopy significantly reduce opioid consumption and pain scores when compared to placebo at 24 h postoperatively. These interventions should be considered in efforts to reduce opioid consumption in patients undergoing knee arthroscopy. More research is needed to determine which interventions can reduce pain outside of the immediate postoperative period and the potential synergistic effects of combining interventions. Level of evidenceII.

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Section: Resultsmentioning

confidence: 99%

“…2). Bali et al [4] found that pre‐emptive naproxen and codeine reduced postoperative pain scores and rescue opioid consumption in the immediate postoperative period when compared to naproxen alone. Table 2 demonstrates the outcomes of all studies included in the review.…”

Section: Resultsmentioning

confidence: 99%

Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis

Gazendam

Ekhtiari

Horner

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Several other studies have also documented the efficacy of nonopioid oral medications after arthroscopy and other orthopaedic procedures. [12][13][14][15][16][17][18][19] Gimbel et al 14 studied a variety of orthopaedic procedures and concluded that celecoxib may serve as a better option for postoperative pain control compared with hydrocodone/acetaminophen. A recent study by Pham et al 19 showed that use of oral NSAIDs (ibuprofen) and limited narcotics resulted in excellent pain relief and patient satisfaction after arthroscopic meniscectomy, which supports our current findings for limited narcotics after an arthroscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

“…There is also controversy over the use of NSAIDs after orthopedic procedures, with several studies indicating that NSAIDs inhibit osteogenesis and delay bone healing. 12,13,32,33 We consider it good practice to recommend taking NSAIDs along with food and to maintain proper hydration to minimize the risk of gastrointestinal and renal complications.…”

Section: Discussionmentioning

confidence: 99%

Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study

Thompson

Klein

Alaia

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the efficacy of oral nonsteroidal anti-inflammatory drugs (NSAIDs) as the primary postoperative pain medication compared with standard oral opioids after arthroscopic shoulder capsulolabral (Bankart) repair for recurrent anterior shoulder instability. Methods This was a single-center, prospective, randomized controlled study. Patients aged 18 to 65 years indicated for arthroscopic shoulder capsulolabral repair for recurrent anterior shoulder instability were included. Postoperatively, patients were prescribed 1 of 2 analgesic regimens: (1) 30 ibuprofen (600 mg every 6 to 8 hours as needed) and 10 tablets of oxycodone/acetaminophen (5/325 mg every 6 hours as needed for breakthrough pain) or (2) 30 tablets oxycodone/acetaminophen (5/325 mg every 6 hours as needed). Subjects completed questionnaires at 24, 48, and 96 hours and 1 week after surgery, which included questions about analgesic medication usage, visual analog scale (VAS) pain score, incidence of adverse events, and patient satisfaction. Results Between December 2017 and May 2019, 80 patients (mean age 31.3 ± 10.4 years) were enrolled. Overall there were no significant differences in VAS pain score or patient satisfaction between the 2 groups. Patients in the opioid-only group had a significantly higher mean opioid consumption on postoperative days (PODs) 2 to 4 (5.5 versus 2.9, P = .05) and after 1 week (11.7 versus 7.9 tablets, P = .05) compared with patients in the NSAID group. Of patients in the NSAID group, 17.5% experienced adverse effects, compared with 35% in the opioid-only group. Conclusions Use of oral NSAIDs with limited breakthrough opioids results in significantly less opioid use after arthroscopic Bankart repair in the first postoperative week compared with opioids only. Both groups used limited amounts of opioids to control postoperative pain. There were no differences in pain levels at any time point postoperatively or satisfaction between patient groups. Level of Evidence II, nonblinded randomized control trial.

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“…They demonstrated that the naproxen sodiumecodeine combination was superior to placebo or naproxen sodium alone. In another study, Bali et al [23] compared the efficacy of preemptive 550 mg naproxen sodium and naproxen sodiumecodeine (550 mg þ 30 mg) in patients undergoing arthroscopic meniscectomy, and they also found that the combination of naproxen sodiumecodeine provided more effective analgesia and lower meperidine consumption than naproxen sodium alone. Similarly, in our study, we found that naproxen sodiumecodeine reduced the pain intensity and also reduced tramadol consumption by almost 50% compared with placebo when used as a supplemental analgesic to tramadol PCA.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the postoperative analgesic effects of paracetamol–codeine phosphate and naproxen sodium–codeine phosphate for lumbar disk surgery

Polat¹,

Peker²,

Gülöksüz³

et al. 2015

The Kaohsiung J of Med Scie

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The aim of this study was to compared the efficacy of paracetamol-codeine phosphate and naproxen sodium-codeine phosphate on postoperative pain and tramadol consumption during the first 24 hours after a lumbar disk surgery. After Ethics Committee approval and informed consent had been obtained, 64 patients were allocated into three groups. Patients received oral paracetamol-codeine (300 mg + 30 mg; Group P), naproxen sodium-codeine (550 mg + 30 mg; Group N), or placebo tablets (Group C) 30 minutes prior to induction of anesthesia. Patient-controlled analgesia was supplied postoperatively using tramadol. Pain intensity, tramadol consumption, and side effects were recorded every 1 hour, 2 hours, 6 hours, 12 hours, and 24 hours after surgery. Whole study period pain intensity (visual analogue scale scores) was lower in Group P (p = 0.007) and Group N (p = 0.001), compared with Group C, however, there was no statistically significant difference between Group P and Group N regarding pain intensity (p > 0.05). Tramadol consumption was lower in Group P and Group N, compared with Group C (p < 0.001), and in turn the lowest incidence of tramadol consumption was detected in Group P compared with Group N (p < 0.001) and Group C (p < 0.001). Side effects were similar between the groups. Preemptive administration of paracetamol-codeine and naproxen sodium-codeine combination significantly reduced tramadol consumption and provided more effective analgesia compared with placebo. The paracetamol-codeine combination was superior to naproxen sodium-codeine with regard to tramadol consumption.

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Comparison of the postoperative analgesic effects of naproxen sodium and naproxen sodium-codeine phosphate for arthroscopic meniscus surgery

Abstract: The combination of naproxen sodium-codeine phosphate provided more effective analgesia than naproxen sodium and did not increase side effects.

Cited by 6 publications

References 24 publications

Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis

Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis

Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study

Comparison of the postoperative analgesic effects of paracetamol–codeine phosphate and naproxen sodium–codeine phosphate for lumbar disk surgery

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