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

Authors : Zeynep ERSOY, Çoşkun ARAZ

Pages : 172-178

Doi:10.18663/tjcl.1260384

View : 29 | Download : 13

Publication Date : 2023-03-23

Article Type : Research Paper

Abstract :Background: Many techniques, including multimodal analgesia, have been used to manage postoperative pain after laparoscopic cholecystectomy insert ignore into journalissuearticles values(LC);. Although the number of studies using intravenous ibuprofen insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(ASA); score I- II, and those scheduled for LC were enrolled in the study. Patients were randomly divided into two groups. The control group insert ignore into journalissuearticles values(n=35); received 800 mg IV ibuprofen insert ignore into journalissuearticles values(group I); in 100 mL saline during surgery, while the acetaminophen group insert ignore into journalissuearticles values(n=35); received 1000 mg insert ignore into journalissuearticles values(group A);. In the postoperative period, all patients received a patient-controlled analgesia insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(NRS);. The incidence of postoperative nausea and vomiting insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(P>0.05);. 24-hour opioid consumption was statistically significantly higher in group A than in group I insert ignore into journalissuearticles values(P 0.05);. PONV rates were similar in the ibuprofen and acetaminophen groups insert ignore into journalissuearticles values(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.
Keywords : İbuprofen, asetaminofen, postoperatif ağrı, analjezi, laparoskopik kolesistektomi