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Preoperative intravenous ibuprofen does not influence postoperative narcotic use in patients undergoing elective hernia repair: a randomized, double-blind, placebo controlled prospective trial

机译:术前静脉使用布洛芬不影响择期疝修补术患者术后麻醉剂的使用:一项随机,双盲,安慰剂对照的前瞻性试验

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Introduction: Inguinal and umbilical hernia repairs are among the most common surgical procedures performed in the US. Optimal perioperative pain control regimens remain challenging and opioid analgesics are commonly used. Preoperative nonsteroidal anti-inflammatory drug (NSAID) administration has been shown to reduce postoperative narcotic requirements. This study sought to evaluate the efficacy of perioperative intravenous (IV) ibuprofen on postoperative pain level and narcotic use in patients undergoing open or laparoscopic inguinal and/or umbilical hernia repair. Methods: A single center, randomized, double-blind placebo-controlled trial involving patients ≥18 years undergoing inguinal and/or umbilical hernia repair was performed. Patients were randomized to receive 800 mg of IV ibuprofen or placebo preoperatively. Outcomes assessed included postoperative pain medication required and visual analog scale (VAS) pain scores. Results: Forty-eight adult male patients underwent inguinal and/or umbilical hernia repair. Patients receiving IV ibuprofen used more oxycodone/acetaminophen (32% vs 13%) and IV hydromorphone (12% vs 8.7%), and fewer combinations of pain medications (44% vs 65.2%) in the first two postoperative hours compared to placebo ( p =0.556). The IV ibuprofen group had more patients pain free (28% vs 8.7%, p =0.087) and lower VAS scores (3.08±2.14 vs 3.95±1.54, p =0.134) at 2 hours postoperatively, compared to the placebo group, however, this was not statistically significant. Similar pain levels at 1, 3, and 7 days, postoperative and similar use of rescue medications in both groups were observed. Conclusion: Preoperative administration of IV ibuprofen did not significantly reduce postoperative pain among patients undergoing elective hernia repair. Considerable variability in postoperative narcotic analgesic requirement was noted, and larger scale studies are needed to better understand the narcotic analgesic requirements associated with IV ibuprofen in inguinal/umbilical hernia repair patients.
机译:简介:腹股沟和脐疝修补术是美国最常见的外科手术之一。最佳的围手术期疼痛控制方案仍然具有挑战性,并且通常使用阿片类镇痛药。术前使用非甾体类抗炎药(NSAID)已显示可减少术后麻醉需要量。本研究旨在评估接受开放或腹腔镜腹股沟和/或脐疝修补术的患者围手术期静脉(IV)布洛芬对术后疼痛水平和麻醉用途的疗效。方法:进行了一项单中心,随机,双盲安慰剂对照试验,该试验涉及≥18岁的接受腹股沟和/或脐疝修补术的患者。患者在术前随机接受800 mg IV布洛芬或安慰剂。评估的结果包括术后所需的止痛药和视觉模拟量表(VAS)疼痛评分。结果:48名成年男性患者接受了腹股沟和/或脐疝修补术。与安慰剂相比,接受静脉布洛芬治疗的患者在术后前两个小时内使用了更多的羟考酮/对乙酰氨基酚(32%比13%)和静脉内氢吗啡酮(12%比8.7%),并且止痛药的组合更少(44%比65.2%)( p = 0.556)。与安慰剂组相比,IV布洛芬组术后2小时的无痛患者更多(28%vs.8.7%,p = 0.087)和较低的VAS评分(3.08±2.14 vs 3.95±1.54,p = 0.134)。这没有统计学意义。两组在术后1、3和7天的疼痛程度相似,术后和使用急救药物的情况相似。结论:术前静脉注射布洛芬不能显着减轻择期疝修补术患者的术后疼痛。注意到术后麻醉镇痛需要量存在很大差异,需要进行大规模研究以更好地了解腹股沟/脐疝修补患者静脉注射布洛芬的麻醉镇痛需要量。

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