Article Text
Abstract
Background and Aims Recent studies show that multimodal analgesia may be the best approach to acute postoperative pain control1. Nonsteroidal anti-inflammatory drugs (NSAIDs) provide effective analgesia and have shown to reduce the opioids consumption2. Despite their analgesic, anti-inflammatory and antipyretic properties, NSAIDs use is associated with gastrointestinal, cardiovascular and renal risk. Intravenous (IV) ibuprofen presents a better safety profile than other NSAIDs and fewer associated adverse effects (AEs) while maintaining adequate analgesic profile.
Methods 60 patients scheduled for hip surgery (demographic characteristics: Table 1) were enrolled in this retrospective observational study and divided in two groups based in postoperative treatment: IV dexketoprofen 50mg TID (n=30) or an IV ibuprofen 600mg TID (n=30). The main objective was to assess postoperative pain with: the visual analog scale (VAS), the quality of postoperative recovery with the Quallity-of-Recovery-15 (QoR-15) score, and on-demand morphine requirements after two days. The incidence of AEs was also studied.
Results VASs, QoR-15 and required morphine dose are summarized in table 2. A statistically significant T-student test was obtained when comparing QoR-15 scores (p=0.018). Greater increases in creatinine levels, digestive AEs and mean arterial pressure were observed in the dexketoprofen group (table 3), obtaining significant results in the T-student in the case of creatinine levels increase (p=0.011).
Conclusions IV ibuprofen shows a favorable security profile resulting in fewer AEs3 compared to subjects who received IV dexketoprofen with equivalent acute postoperative pain control. This drug may be safely given as a component of a multimodal management strategy, especially in those patients at risk of kidney function impairment.