Comparison of intravenous ibuprofen and acetaminophen for postoperative multimodal pain management in bariatric surgery: A randomized controlled trial

摘要

Study objectiveMultimodal analgesic strategies are recommended to decrease opioid requirements and opioid-induced respiratory complications in patients undergoing laparoscopic bariatric surgery. Recent studies have demonstrated that intravenous ibuprofen decreases opioid consumption compared with placebo. The primary aim of this study was to compare the effect of intravenous ibuprofen and intravenous acetaminophen on opioid consumption. We also aimed to compare postoperative pain levels and side effects of the drugs. DesignRandomized, double-blinded study. SettingUniversity hospital. PatientsEighty patients, aged 18–65?years, (ASA physical status II-III) undergoing laparoscopic sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass surgery were included in this study. InterventionsPatients were randomized to receive 800?mg ibuprofen or 1?g acetaminophen intravenously every 6?h for the first 24?h following surgery; in addition, patient-controlled analgesia with morphine was administered. MeasurementsPostoperative morphine consumption in the first 24?h, visual analog scale (VAS) pain scores at rest and with movement, and opioid related side effects were assessed. In addition, time to passage of flatus, surgical complications, lengths of intensive care unit and hospital stay, and laboratory parameters were recorded. Main resultsThe mean morphine consumption was 23.94?±?13.89?mg in iv ibuprofen group and 30.23?±?13.76?mg in the acetaminophen group [mean difference: -6.28 (95% CI, ?12.70, 0.12);P?=?0.055]. The use of intravenous ibuprofen was associated with reduction in pain at rest (AUC, 1- to 24-h,P?