Efficacy of Intravenous Ibuprofen and Intravenous Paracetamol in Multimodal Pain Management of Postoperative Pain After Percutaneous Nephrolithotomy

Uçar, Muharrem; Erdoğan, Mehmet Ali; Şanlı, Mukadder; Çolak, Yusuf Ziya; Aydoğan, Mustafa Said; Yücel, Aytaç; Özgül, Ülkü

doi:10.1016/j.jopan.2021.10.018

Cited by 9 publications

(29 citation statements)

References 25 publications

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“…Tere was no difference in the incidence of AEs between groups, consistent with the aforementioned study. In addition, several studies evaluated series of investigational formulations doses IVIB and found no renal dysfunction, gastrointestinal toxicity or bleeding events requiring blood transfusion for treatment [12,28,30,36,41]. Briefy, in line with the efectiveness and safety assessment of previous studies, IVIB 400 mg and IVIB 800 mg were safe and reliable dosages for acute postoperative pain, and also superiorly well-tolerated for patients in this protocol of the study.…”

Section: Safetysupporting

confidence: 55%

“…So far, the vast majority of postoperative pain studies focus on IVIB 800 mg. A narrative summary described that 344 adult patients and healthy volunteers were included in these 9 studies, 200 of these subjects received IVIB, and the remaining 144 received either placebo or a comparator medication, suggesting that the patients with IVIB 800 mg experienced less postoperative pain, decreased opioid use, improved quality of recovery, and even used less over-the-counter medication [12]. Recently, the IVIB 800 mg infusion was utilized for the management of postoperative pain after percutaneous nephrolithotomy, gynecologic laparoscopy, and orthognathic surgery, which suggested that it had benefcial efect in pain control, and even provided efective preventive analgesia when administered 30 min before surgery [35][36][37]. As well, satisfaction with pain management was documented in diferent clinical trials, and confrmed that satisfaction was signifcantly higher with both doses than with placebo [34,36].…”

Section: Efcacymentioning

confidence: 99%

“…Recently, the IVIB 800 mg infusion was utilized for the management of postoperative pain after percutaneous nephrolithotomy, gynecologic laparoscopy, and orthognathic surgery, which suggested that it had benefcial efect in pain control, and even provided efective preventive analgesia when administered 30 min before surgery [35][36][37]. As well, satisfaction with pain management was documented in diferent clinical trials, and confrmed that satisfaction was signifcantly higher with both doses than with placebo [34,36]. Arguably, ibuprofen plays a very benefcial role in urgent postoperative pain relief, which is non-negligible to optimize patient comfort and improving patient prognosis.…”

Section: Efcacymentioning

confidence: 99%

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Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-ControlledDouble-Blind Clinical Trial

Zhou

et al. 2023

Pain Research and Management

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Objective. To evaluate the analgesic efficacy and safety of different does of intravenous ibuprofen (IVIB) in the treatment of postoperative acute pain. Methods. Patients with an intravenous (IV) patient-controlled analgesia device after abdominal or orthopedic surgery were randomly divided into placebo, IVIB 400 mg, and IVIB 800 mg groups. The first dosage of study medicines was given intravenously 30 minutes (min) before surgery ended, followed by six hours (h) intervals for a total of eight doses following surgery. The demographic characteristics and procedure data, cumulative morphine consumption, the visual analog scale (VAS), the area under the curve (AUC) of VAS, patient satisfaction score (PSS), the rates of treatment failure (RTF), and adverse events (AEs) and serious adverse event (SAEs) were recorded during the period of trial. Result. A total of 345 patients were enrolled in the full analysis set (FAS), and of 326 participants were valid data set (VDS). Demographic characteristics, disease features, and medical history of patients were not significantly different between groups. Total morphine consumption of the IVIB 400 mg group (11.14 ± 7.14 mg; P = 0.0011) and the IVIB 800 mg group (11.29 ± 6.45 mg; P = 0.0014) was significantly reduced compared with the placebo group (14.51 ± 9.19 mg) for 24 h postoperatively, there was no significant difference between the IVIB 400 mg and IVIB 800 mg groups ( P = 0.9997). The placebo group had significantly higher VAS and the AUCs of VAS than those in the IVIB 400 mg and the IVIB 800 mg groups at rest and movement for 24 h postoperatively ( P < 0.05), and there was no significant difference between the IVIB 400 mg and IVIB 800 mg groups ( P > 0.05). RTF was slightly higher in the placebo group than IVIB 400 mg group and 800 mg group, and no statistical significance ( P < 0.690). PSS in the IVIB 400 mg ( P = 0.0092) and the IVIB 800 mg groups ( P = 0.0011) was higher than the placebo group for pain management, there was also no significant difference between the IVIB 400 mg and IVIB 800 mg groups ( P = 0.456). The incidence of RTF ( P = 0.690) and AEs ( P > 0.05) were not different among the three groups. Conclusion. Intermittent IV administration of ibuprofen 400 mg or 800 mg within 24 h after surgery in patients undergoing abdominal and orthopedic surgery significantly decreased morphine consumption and relieved pain, without increasing the incidence of AEs.

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Section: Safetysupporting

confidence: 55%

Section: Efcacymentioning

confidence: 99%

Section: Efcacymentioning

confidence: 99%

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Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-ControlledDouble-Blind Clinical Trial

Zhou

et al. 2023

Pain Research and Management

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“…We also compared two different combinations of the drugs (IV ibuprofen-tramadol and IV acetaminophentramadol) for treating mild and moderate-to-severe pain as an adjunct to opioids. Results showed that total tramadol consumption after surgery was significantly lower in the ibuprofen group compared with the acetaminophen group [27]. The IV form of ibuprofen has been studied in patients undergoing orthopedic surgery, abdominal hysterectomy, or LC; it is reported to be relatively safe and effective [21,23,28].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intravenous Ibuprofen and Acetaminophen on Postoperative Pain and Tramadol Consumption in Laparoscopic Cholecystectomy: Prospective, Randomized, Double-blinded Clinical Trial

Ersoy

Araz

2023

Turkish Journal of Clinics and Laboratory

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Background: Many techniques, including multimodal analgesia, have been used to manage postoperative pain after laparoscopic cholecystectomy (LC). Although the number of studies using intravenous ibuprofen (IV) is still limited, ibuprofen has been shown to have a potential role in managing postoperative pain. The primary outcome of this study is to evaluate and compare the impact of IV forms of ibuprofen and acetaminophen on 24-hour postoperative opioid consumption and pain management in patients undergoing LC. The second outcome of the study is to evaluate the impact of ibuprofen and acetaminophen on opioid-related adverse events (ORAE). Materials and Methods: This study was a prospective, randomized, double-blind clinical trial. Following ethical committee approval, 70 patients aged 18 to 65, American Society of Anesthesiology (ASA) score I- II, and those scheduled for LC were enrolled in the study. Patients were randomly divided into two groups. The control group (n=35) received 800 mg IV ibuprofen (group I) in 100 mL saline during surgery, while the acetaminophen group (n=35) received 1000 mg (group A). In the postoperative period, all patients received a patient-controlled analgesia (PCA) device with tramadol. The PCA device was set to a bolus dose of 10 mg and had a lockout time of 15 minutes. A blinded pain nurse assessed postoperative analgesia at 1, 2, 4, 6, 12, and 24 hours using a numerical rating scale (NRS). The incidence of postoperative nausea and vomiting (PONV), total tramadol consumption, and the need for additional analgesics during the 24-hour postoperative period were recorded. Results: Seventy patients who underwent LC participated in this study. The use of analgesic medications was statistically lower in group I than in the other group A. NRS scores between the IV ibuprofen and acetaminophen groups were statistically similar at 1, 2, 4, 6, 12, and 24 hours postoperatively (P>0.05). 24-hour opioid consumption was statistically significantly higher in group A than in group I (P0.05). PONV rates were similar in the ibuprofen and acetaminophen groups (P>0.05). ORAEs were similar between groups. Conclusion: Ibuprofen as part of tramadol-based multimodal analgesia reduced tramadol consumption compared to acetaminophen during the first 24 hours postoperatively following elective LC surgery. The IV ibuprofen-tramadol combination appeared superior to an acetaminophen-tramadol combination. ORAEs were similar in both groups.

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“…The assessment of the risk of bias was summarized in Figure 2, Figure 3, and Supplementary Table 3. 56.3% of trials (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) had an unclear risk of bias owing to insufficient information about random sequences, allocation concealment, and the blinding of participants, personnel, and outcome assessors. 28.1% of trials (40)(41)(42)(43)(44)(45)(46)(47)(48) showed a low risk of bias and 15.6% of trials (49-53) had a high risk of blinding of participants and personnel, selective reporting, or other bias.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

Intravenous Ibuprofen in Postoperative Pain and Fever Management in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhou¹,

Chen²,

Wang

et al. 2023

Preprint

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Aims: Intravenous ibuprofen (IVIB) has been approved in the treatment of postoperative pain and fever in adults, but the application of multiple- or single- dosage IVIB remains divergent in clinical practice. This study aims to evaluate the efficacy and safety of IVIB in the management of postoperative pain and fever in adults who were unable to take oral medicine. Methods: A systematic review and meta-analysis was conducted based on randomized controlled trials (RCTs) regarding postoperative pain and fever management comparing IVIB with placebo, or other analgesic and antipyretic agents from 8 databases. Risk of bias and quality of evidence assessment were performed. The primary outcomes mainly included visual analogue scale (VAS) score within postoperative 24h and the reduction of temperature. Results: Twenty-three RCTs with 3716 participants were included. For postoperative pain, moderate-to-low certainty evidence indicated that IVIB was associated with lower postoperative VAS scores than placebo, with MD ranging between -3.53 (95% CI, -4.32 to -2.75) at 0 minute to -0.96 (95% CI, -1.35 to -0.57) at 24 hours. Compared to intravenous acetaminophen, IVIB appeared lower VAS scores (MD, -1.54 at 0min; -0.36 at 24h). For fever, IVIB appeared satisfactory antipyretic efficiency in a short period of time, but there was no difference between IVIB and intravenous acetaminophen. Moderate-to-low certainty evidence indicated that IVIB was well tolerated in both pain and fever management. Conclusions: Moderate-to-low certainty evidence supported that adults with postoperative pain and fever who were unable to take oral medicine would benefit from IVIB.

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Efficacy of Intravenous Ibuprofen and Intravenous Paracetamol in Multimodal Pain Management of Postoperative Pain After Percutaneous Nephrolithotomy

Cited by 9 publications

References 25 publications

Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-ControlledDouble-Blind Clinical Trial

Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-ControlledDouble-Blind Clinical Trial

Efficacy of Intravenous Ibuprofen and Acetaminophen on Postoperative Pain and Tramadol Consumption in Laparoscopic Cholecystectomy: Prospective, Randomized, Double-blinded Clinical Trial

Intravenous Ibuprofen in Postoperative Pain and Fever Management in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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