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A Randomized, Placebo-Controlled, Double-Blind Study that Evaluates Efficacy of Intravenous Ibuprofen and Acetaminophen for Postoperative Pain Treatment Following Laparoscopic Cholecystectomy Surgery

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Ibuprofen is a NSAID that has anti-inflammatory, antipyretic, and analgesic effects. The oral form of the drug has been used safely for a long time and is one of the most preferred NSAIDs. It has been shown that ibuprofen is effective in the treatment of postoperative pain; however, there have not been sufficient studies on ibuprofen. We evaluated and compared the influence of IV forms of ibuprofen and acetaminophen on pain management and opioid consumption on patients undergoing laparoscopic cholecystectomy surgery.

Methods

Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen; group A (group acetaminophen, n = 30) was administered 1000 mg of IV acetaminophen; and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively.

Results

Pain scores in group I and group A at all time periods were lower than those in group C (p < 0.05). Group I had significantly lower VAS scores than those in group A at all time periods postoperatively (p < 0.05). Those in group C had significantly higher opioid consumption than the other groups (p < 0.05). Opioid consumption in group I at all time periods postoperatively was significantly lower than those in group A (p < 0.05). Group I had statistically lower rescue medication than the other groups at all time periods.

Conclusion

Our study suggested that IV ibuprofen resulted in lower pain scores and reduced opioid use compared with acetaminophen postoperatively in the first 24 h in patients undergoing laparoscopic cholecystectomy surgery.

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References

  1. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–540, table of contents.

    Article  Google Scholar 

  2. Rathmell JP, Wu CL, Sinatra RS, Ballantyne JC, Ginsberg B, Gordon DB, et al. Acute post-surgical pain management: a critical appraisal of current practice. Reg Anesth Pain Med. 2006; 31: 1–42. doi:https://doi.org/10.1016/j.rapmg.2006.05.002

    Article  PubMed  Google Scholar 

  3. Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Brish J Anaesth 2001;87:62–72.

    Article  CAS  Google Scholar 

  4. American Society of Anesthesiologists Task Force on Acute Pain ManagementPractice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology 2012;116:248–73.

    Article  Google Scholar 

  5. Soper NJ, Stockmann PT, Dunnegan DL, et al. Laparoscopic cholecystectomy. The new ‘gold standard’? Arch Surg 1992;127:917–21. discussion 921–913.

    Article  CAS  Google Scholar 

  6. Donatsky AM, Bjerrum F, Go¨genur I. Surgical techniques to minimize shoulder pain after laparoscopic cholecystectomy. A systematic review. Surg Endosc. 2013;27:2275–82.

    Article  Google Scholar 

  7. Oderda GM, Said Q, Evans RS, et al. Opioid-related adverse drug events in surgical hospitalizations: Impact on costs and length of stay. Ann Pharmacother. 2007;41:400–406.

    Article  Google Scholar 

  8. Beilin B, Bessler H, Mayburd E, et al. Effects of preemptive analgesia on pain and cytokine production in the postoperative period. Anesthesiology. 2003;98:151–155.

    Article  CAS  Google Scholar 

  9. Svensson CI, Yaksh TL. The spinal phospholipasecyclooxygenase- prostanoid cascade in nociceptive processing. Annu Rev Pharmacol Toxicol. 2002;42:553–583.

    Article  CAS  Google Scholar 

  10. Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77:1048–1056.

    Article  CAS  Google Scholar 

  11. Bebenista MJ, Nowak JZ. Paracetamol: Mechanism Of Action, Applications And Safety Concern. Acta Poloniae Pharmaceutica-Drug Research, Vol. 71 No. 1 pp. 11–23, 2014.

    Google Scholar 

  12. Scott LJ. Intravenous ibuprofen: in adults for pain and fever. Drugs 2012;72:1099–109.

    Article  CAS  Google Scholar 

  13. Gago Martinez A, Escontrela Rodriguez B, Planas Roca A, et al. Intravenous ibuprofen for treatment of post-operative pain: a multicenter, double blind, placebo-controlled, randomized clinical trial. PLoS One 2016;11:e0154004.

    Article  Google Scholar 

  14. Elif Oral Ahiskalioglu, MD, Ali Ahiskalioglu, Pelin Aydin, Ahmet Murat Yayik, Ayetullah Temiz. Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine (2017) 96:8.

    Google Scholar 

  15. Kroll PB, Meadows L, Rock A, et al. A multicenter, randomized, doubleblind, placebo-controlled trial of intravenous ibuprofen (i.v.-ibuprofen) in the management of postoperative pain following abdominal hysterectomy. Pain Pract 2011;11:23–32.

    Article  Google Scholar 

  16. Singla N, Rock A, Pavliv L. A multi-center, randomized, double-blind placebo-controlled trial of intravenous-ibuprofen (IV-ibuprofen) for treatment of pain in post-operative orthopedic adult patients. Pain Med. 2010;11(8):1284–93.

    Article  Google Scholar 

  17. Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009; 22: 588–593. https://doi.org/10.1097/ACO.0b013e328330373a PMID: 19606021

  18. Ashburn MA, Caplan RA, Carr DB, et al. Practice guidelines for acute pain management in the perioperative setting. An updated report by the American Society of Anesthesiologists task force on acute pain management. Anesthesiology 2004; 100:1573–1581.

    Article  Google Scholar 

  19. Ekstein P, Szold A, Sagie B, Werbin N, Klausner JM, Weinbroum AA. Laparoscopic surgery may be associated with severe pain and high analgesia requirements in the immediate postoperative period. Ann Surg. 2006;243:41–6.

    Article  Google Scholar 

  20. Blichfeldt-Eckhardt MR, Ording H, Andersen C, Licht PB, Toft P. Early visceral pain predicts chronic pain after laparoscopic cholecystectomy. Pain. 2014;155(11):2400–7.

    Article  Google Scholar 

  21. Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Canadian journal of anaesthesia = Journal canadien d'anesthesie. 2001;48(10):1000–10.

    Article  CAS  Google Scholar 

  22. Gozeler MS, Sakat MS, Kilic K, Ozmen O, Can A, Ince I. Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty? American journal of otolaryngology 2018.

  23. Çelik EC, Kara D, Koc E, Yayik AM. The comparison of single-dose preemptive intravenous ibuprofen and paracetamol on postoperative pain scores and opioid consumption after open septorhinoplasty: a randomized controlled study. European Archives of Oto-Rhino-Laryngology; 2018. doi: https://doi.org/10.1007/s00405-018-5065-6

  24. Kroll PB. Intravenous ibuprofen for postoperative pain. Pain Manag. 2012; 2:47–54. doi: https://doi.org/10.2217/pmt.11.68

  25. Macario A, Royal MA. A literature review of randomized clinical trials of intravenous acetaminophen (paracetamol) for acute postoperative pain. Pain Pract 2011; 11: 290–6

    Article  Google Scholar 

  26. McNicol ED, Tzortzopoulou A, Cepeda MS, Francia MB, Farhat T, Schumann R. Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis. Br J Anaesth 2011; 106: 764–75

    Article  CAS  Google Scholar 

  27. R.A. Moore, S. Derry, P.J. Wiffen, S. Straube, D.J. Aldington. Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain 19 (2015) 1213—1223.

    Article  CAS  Google Scholar 

  28. Southworth S, Peters J, Rock A, Pavliv L. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen 400 and 800 mg every 6 hours in the management of postoperative pain. Clin Ther. 2009;31(9):1922–35.

    Article  CAS  Google Scholar 

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Author notes

  1. Mursel Ekinci & Bahadır Ciftci

    Present address: Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey

Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey

    Emine Arzu Köse & Muhammet Ahmet Karakaya

  2. Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, Yakutiye, 25070, Erzurum, Turkey

    Erkan Cem Celik

  3. Department of General Surgery, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey

    Yasar Ozdenkaya

Authors
  1. Mursel Ekinci
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  2. Bahadır Ciftci
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  4. Emine Arzu Köse
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  5. Muhammet Ahmet Karakaya
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Each author has participated significantly in the work and takes public responsibility for it.

Corresponding author

Correspondence to Bahadır Ciftci.

Ethics declarations

Ethical approval was obtained from the Istanbul Medipol University Committee for this randomized, double-blind, placebo-controlled study. Written informed consent was obtained from all patients.

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The authors declare that they have no conflict of interest.

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Ekinci, M., Ciftci, B., Celik, E.C. et al. A Randomized, Placebo-Controlled, Double-Blind Study that Evaluates Efficacy of Intravenous Ibuprofen and Acetaminophen for Postoperative Pain Treatment Following Laparoscopic Cholecystectomy Surgery. J Gastrointest Surg 24, 780–785 (2020). https://doi.org/10.1007/s11605-019-04220-1

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  • DOI: https://doi.org/10.1007/s11605-019-04220-1

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