Intravenous ibuprofen as an adjunct in acute postoperative pain: A Review

Authors

  • Alisha Shrestha The third Hospital of Xiangya, Central South University
  • Dong Huang The third Hospital of Xiangya, Central South University

Keywords:

Acute pain, Ibuprofen, Intravenous administration, NSAIDs, Opioids, Postoperative pain

Abstract

Background: Postoperative pain can have a significant effect on patient recovery. Studies suggest that 82% patients experience some pain following surgery, of those 47% complaining of moderate pain, 39% experiencing severe to very severe pain. The failure to adequately treat postoperative pain is due to limitations of monotherapy with opioid analgesics. Intravenous ibuprofen is a nonsteroidal anti-inflammatory drug with anti-inflammatory, antipyretic, and analgesic properties that may be related to prostaglandin synthetase inhibition and have been shown to reduce opioid requirements with better postoperative pain management. This paper reviews analgesic outcomes of intravenous ibuprofen as an adjunct to opioid for acute postoperative pain in adults.

Methods: Relevant studies were searched using cochrane database of systematic reviews, embase and pubmed databases using key words about intravenous ibuprofen and postoperative pain that were appropriate to each database.

Results: Tools to assess pain intensity such as visual analog scale, verbal response scale and self-report of pain scores at rest and with movement have been studied. Multimodal approach with preemptive use of nonsteroidal anti-inflammatory drugs for treatment of postoperative pain is considered.

Conclusion: Randomized controlled trials and other studies concluded that postoperative pain control protocols can now consider inclusion of intravenous ibuprofen as an adjunct in multimodal approach to offer patients a significant analgesic benefit while reducing the risks associated with opioid administration.

Author Biographies

Alisha Shrestha, The third Hospital of Xiangya, Central South University

Master in Anesthesiology and Intensive Care Unit, Department of Anesthesiology, The Third hospital of Xiangya, Central South University, China

Dong Huang, The third Hospital of Xiangya, Central South University

Professor, Department of Anesthesia, The third Hospital of Xiangya, Central South University

References

1. Bookstaver PB, Miller AD, Rudisill CN, Norris LB. Intravenous ibuprofen: the first injectable product for the treatment of pain and fever. J Pain Res 2010;3:67-79.
2. 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;97:534-40.
3. Costantini R, Affaitati G, Fabrizio A, Giamberardino MA. Controlling pain in the post-operative setting. Int J ClinPharmacolTher 2011;49:116-27.
4. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med 2010;11:1859-71.
5. Sherwood GD, McNeill JA, Starck PL, Disnard G. Changing acute pain management outcomes in surgical patients. Aorn J 2003;77:377-80.
6. Ramsay MA. Acute postoperative pain management. Proc 2000;13:244-7.
7. Kehlet H, Dahl JB. The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesth Analg 1993;77:1048-56.
8. Elvir-Lazo OL, White PF. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin 2010;28:217-24.
9. White PF. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Investig Drugs 2008;9:76-82.
10. Gordon DB, Dahl JL, Miaskowski C, McCarberg B, Todd KH, Paice JA, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Arch Intern Med 2005;165:1574-80.
11. Practice guidelines for acute pain management in the perioperative setting. A report by the American Society of Anesthesiologists Task Force on Pain Management, Acute Pain Section. Anesthesiology 1995;82:1071-81.
12. Kokki H, Kumpulainen E, Lehtonen M, Laisalmi M, Heikkinen M, Savolainen J, et al. Cerebrospinal fluid distribution of ibuprofen after intravenous administration in children. Pediatrics 2007;120:1002-8.
13. Ohlsson A, Walia R, Shah SS. Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants. Cochrane Database Syst Rev 2013;30.
14. Morris PE, Promes JT, Guntupalli KK, Wright PE, Arons MM. A multi-center, randomized, double-blind, parallel, placebo-controlled trial to evaluate the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for the treatment of fever in critically ill and non-critically ill adults. Crit Care 2010;14:30.
15. Promes JT, Safcsak K, Pavliv L, Voss B, Rock A. A prospective, multicenter, randomized, double-blind trial of IV ibuprofen for treatment of fever and pain in burn patients. J Burn Care Res 2011;32:79-90.
16. Sittl R, Irnich D, Lang PM. Update on preemptive analgesia : options and limits of preoperative pain therapy. Anaesthesist 2013;62:789-96.
17. Dahl JB, Kehlet H. The value of pre-emptive analgesia in the treatment of postoperative pain. Br J Anaesth 1993;70:434-9.
18. Titchen T, Cranswick N, Beggs S. Adverse drug reactions to nonsteroidal anti-inflammatory drugs, COX-2 inhibitors and paracetamol in a paediatric hospital. Br J Clin Pharmacol 2005;59:718-23.
19. Hoppmann RA, Peden JG, Ober SK. Central nervous system side effects of nonsteroidal anti-inflammatory drugs. Aseptic meningitis, psychosis, and cognitive dysfunction. Arch Intern Med 1991;151:1309-13.
20. 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;31:1922-35.
21. 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;11:1284-93.
22. Kroll PB, Meadows L, Rock A, Pavliv L. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen (i.v.-ibuprofen) in the management of postoperative pain following abdominal hysterectomy. Pain Pract 2011;11:23-32.
23. Somogyi AA, Barratt DT, Coller JK. Pharmacogenetics of opioids. Clin Pharmacol Ther 2007;81.429-44.
24. Pasternak GW. Opiate pharmacology and relief of pain. J Clin Oncol 2014;32:1655-61.
25. Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol 2009;22:588-93.
26. Simon LS. Nonsteroidal anti-inflammatory drugs and their risk: a story still in development. Arthritis Res Ther 2013;15:24.
27. Warner TD, Giuliano F, Vojnovic I, Bukasa A, Mitchell JA, Vane JR. Nonsteroid drug selectivities for cyclo-oxygenase-1 rather than cyclo-oxygenase-2 are associated with human gastrointestinal toxicity: a full in vitro analysis. Proc Natl Acad Sci U S A 1999;96:7563-8.
28. Antman EM, Bennett JS, Daugherty A, Furberg C, Roberts H, Taubert KA. Use of nonsteroidal antiinflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association. Circulation. 2007;115:1634-42.

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Published

2015-02-26

How to Cite

Shrestha, A., & Huang, D. (2015). Intravenous ibuprofen as an adjunct in acute postoperative pain: A Review. Journal of Society of Anesthesiologists of Nepal, 2(1), 21-24. Retrieved from http://www.jsan.org.np/jsan/index.php/jsan/article/view/29

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Section

Review Article