Comparative Analgesic Efficacy of Intravenous Ibuprofen versus Intravenous Paracetamol Following Laparoscopic Cholecystectomy
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Abstract
Objective: To comparatively evaluate how intravenous ibuprofen and intravenous paracetamol affect patients undergoing laparoscopic cholecystectomy in terms of the postoperative pain score, first request rescue analgesia time, plus total rescue analgesic use.
Methodology: Over a period of one year, this quasi-experimental study; conducted in anesthesia department of Jinnah Hospital in Lahore. Two groups of thirty patients each were formed from total of sixty individuals who met the inclusion criteria. Group B received 1 g of IV paracetamol during a 30-minute period, while Group A received 400 mg of ibuprofen in 100 ml of normal saline. At 0, 2, 4, and 6 hours after surgery, postoperative pain scores were noted. Total amount of both tramadol consumed and time to initial rescue analgesia were recorded.
Results: At 0 hour, mean VAS was 0.27 ± 0.45 (ibuprofen) vs 0.53±0.51 (paracetamol) (p = 0.035). At 2 hours: 0.40±0.50 vs 0.73±0.45 (p = 0.009); at 4 hours: 1.33±0.71 vs 2.03±0.67 (p < 0.001); at 6 hours: 1.83±0.83 vs 2.93±0.78 (p < 0.001). First rescue analgesia was needed at 6 hours in 2 (6.7%) patients in Group A, and at 4 hours in 5 (16.7%) and at 6 hours in 7 (23.3%) patients in Group B (p=0.007). Total tramadol used was 102.75±7.42 mg vs 153.63±52.13 mg (p=0.207).
Conclusion: When compared to IV paracetamol, intravenous ibuprofen was associated to reduced postoperative pain scores and a delayed need for rescue analgesia following laparoscopic cholecystectomy. The ibuprofen group consumed less rescue analgesics overall, but the difference was not statistically significant. IV ibuprofen may be considered as part of multimodal postoperative analgesia.
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