Comparison of Intraoperative Intravenous Ibuprofen versus Intravenous Paracetamol for Post-Operative Pain Relief in Patients Undergoing Laparoscopic Cholecystectomy

Waqas Tariq; Ahmed Sarfaraz; Ahmad Rafique; Muhammad Asad Sultan khan; Hamza Bin Tariq; Khalid Buland

doi:10.51253/pafmj.v75i3.7872

Authors

Waqas Tariq Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ahmed Sarfaraz Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Ahmad Rafique Department of Surgery, Mayo Hospital, Lahore Pakistan
Muhammad Asad Sultan khan Department of Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Hamza Bin Tariq Department of Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Khalid Buland Department of Anesthesia, Combined Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i3.7872

Keywords:

Ibuprofen, Laparoscopic Cholecystectomy, Paracetamol.

Abstract

Objective: To compare intraoperative intravenous Ibuprofen versus intravenous Paracetamol for post-operative pain relief in patients undergoing laparoscopic cholecystectomy.

Study Design: Quasi-experimental study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Nov 2021.

Methodology: The study was conducted on 400 patients who underwent laparoscopic cholecystectomy during the study period. Patients were randomized into two groups. Group A received intravenous Ibuprofen, while Group B received intravenous Paracetamol during the surgical procedure. The pain at the surgical site was recorded on the visual analog scale (VAS) at 2 hours and 6 hours after the surgical procedure. The difference in post-operative pain and the requirement of opioid analgesia was compared in both groups via the chi-square test.

Results: Out of 400 patients randomized into two groups, 198(49.5%) were categorized into Group A, and 202(50.5%) were categorized into Group B. 290(72.5%) were female, while 110(27.5%) were male. The mean age of patients who underwent laparoscopic surgery in our study was 40.24±7.69 years. Patients who received intravenous Ibuprofen had more chances of not having significant postoperative pain at 02 and 06 hours after the surgery as compared to those who received intravenous Paracetamol (p-value<0.05).

Conclusion: The Use of intravenous Ibuprofen during laparoscopic surgery emerged as better management for early post-operative pain as compared to the use of intravenous Paracetamol. There was no difference in the use of opioid analgesia in the early postoperative period in both groups.

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References

Vitale A, Lai Q. New trends and perspectives in hepatobiliary surgery: preface. Transl Gastroenterol Hepatol 2018; 3: 99.

https://doi.org/10.21037/tgh.2018.11.06

Artifon EL, Loureiro JF, Baron TH, Fernandes K, Kahaleh M, Marson FP. Surgery or EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after ERCP failure. Endosc Ultrasound 2015; 4(3): 235-243.

Hong KS, Noh KT, Min SK, Lee HK. Selection of surgical treatment types for intrahepatic duct stones. Korean J Hepatobiliary Pancreat Surg 2011; 15(3): 139-145.

Majeed MH, Nadeem R, Khokhar MA, Qaisar MN. Adequacy of Pain Control in Patients With Advanced Cancer in Pakistan. J Palliat Care 2019; 34(2): 126-131.

https://doi.org/10.1177/0825859718800490

Hamza M, Dionne RA. 2020 Foresight: Envisioning Therapeutic Innovations for Pain. Drug Discov Today Ther Strateg 2009; 6(3): 113-119.

https://doi.org/10.1016/j.ddstr.2010.10.002

Southworth SR, Sellers JA. Narrative Summary of Recently Published Literature on Intravenous Ibuprofen. Clin Ther 2020; 42(7): 1210-1221.

https://doi.org/10.1016/j.clinthera.2020.05.004

Karaca O, Pınar HU, Turk E, Dogan R, Ahiskalioglu A, Solak SK. Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy. J Invest Surg 2019; 32(3): 189-195.

https://doi.org/10.1080/08941939.2017.1386738

Ahiskalioglu EO, Ahiskalioglu A, Aydin P, Yayik AM, Temiz A. Effects of single-dose preemptive intravenous Ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine 2017; 96(8): e6200.

https://doi.org/10.1097/MD.0000000000006200

Ekinci M, Ciftci B, Celik EC, Köse EA, Karakaya MA, Ozdenkaya Y. 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 2020; 24(4): 780-785.

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

Ans, M, Maqsood, R, Malhi A, Mahmood K, Feroze N, Zulfiqar U. Comparison of analgesic effect of intravenous paracetamol vs intravenous ketorolac on post-operative pain after abdominal surgery. Pak Armed Forces Med J 2020; 70 (2): 286-190.

Sarkar S, Rastogi A, Haldar R, Kumar A, Singh S. An audit to study pain after laparoscopic cholecystectomy with the use of nonopioid analgesics. Indian J Pain 2017; 31(2): 170-174.

Wakabayashi G, Iwashita Y, Hibi T, Takada T, Strasberg SM, Asbun HJ, et al. Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018; 25(1): 73-86.

https://doi.org/10.1002/jhbp.517

Sharma R, Gupta R, Choudhary R, Singh Bajwa SJ. Postoperative Analgesia with Intravenous Paracetamol and Dexmedetomidine in Laparoscopic Cholecystectomy Surgeries: A Prospective Randomized Comparative Study. Int J Appl Basic Med Res 2017; 7(4): 218-222. https://doi.org/10.4103/ijabmr.IJABMR_25_17

Sparber LS, Lau CS, Vialet TS, Chamberlain RS. Preoperative intravenous Ibuprofen does not influence postoperative narcotic use in patients undergoing elective hernia repair: a randomized, double-blind, placebo controlled prospective trial. J Pain Res 2017; 10: 1555-1560.

https://doi.org/10.2147/JPR.S132836

Lee HM, Park JH, Park SJ, Choi H, Lee JR. Comparison of Monotherapy Versus Combination of Intravenous Ibuprofen and Propacetamol (Acetaminophen) for Reduction of Postoperative Opioid Administration in Children Undergoing Laparoscopic Hernia Repair: A Double-Blind Randomized Controlled Trial. Anesth Analg 2021; 133(1): 168-175.

https://doi.org/10.1213/ANE.0000000000005284

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. Eur Arch Otorhinolaryngol 2018; 275(9): 2259-2263.

https://doi.org/10.1007/s00405-018-5065-6

Ciftci B, Ekinci M, Celik EC, Kaciroglu A, Karakaya MA, Demiraran Y, et al. Comparison of Intravenous Ibuprofen and Paracetamol for Postoperative Pain Management after Laparoscopic Sleeve Gastrectomy. A Randomized Controlled Study. Obes Surg 2019; 29(3): 765-770.

https://doi.org/10.1007/s11695-018-3613-1

Erdogan Kayhan G, Sanli M, Ozgul U, Kirteke R, Yologlu S. Comparison of intravenous Ibuprofen and acetaminophen for post-operative multimodal pain management in bariatric surgery: A randomized controlled trial. J Clin Anesth 2018; 50: 5-11.

https://doi.org/10.1016/j.jclinane.2018.06.030