Skip to main content
Top
Published in: Obesity Surgery 3/2019

01-03-2019 | Original Contributions

Comparison of Intravenous Ibuprofen and Paracetamol for Postoperative Pain Management after Laparoscopic Sleeve Gastrectomy. A Randomized Controlled Study

Authors: Bahadır Ciftci, Mursel Ekinci, Erkan Cem Celik, Ahmet Kaciroglu, Muhammet Ahmet Karakaya, Yavuz Demiraran, Yasar Ozdenkaya

Published in: Obesity Surgery | Issue 3/2019

Login to get access

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is defined as the first-step bariatric surgery for the treatment of obesity. Opioid analgesics are often preferred for pain management because of their strong analgesic potentials. However, opioids have undesirable adverse effects.

Objectives

The objective of this study is to evaluate and compare the influence of IV forms of ibuprofen and paracetamol on pain management and opioid consumption on patients undergoing LSG surgery.

Setting

This study was conducted at Istanbul Medipol University Hospital.

Methods

Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen, group P (group paracetamol, n = 30) was administered 1000 mg of IV paracetamol, and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively.

Results

This study included 90 patients who underwent LSG. The use of rescue medication in group I was statistically lower than the other groups. VAS scores in group I and group P at recovery and at 2, 4, 8, 12, and 24 h were lower than those in group C. In particular, the VAS scores in group I at the first 2 h postoperatively were significantly lower than those in group P (p < 0.05). Opioid consumption in group C was significantly higher than the other groups (p < 0.05).

Conclusion

Our study suggested that IV ibuprofen resulted in lower pain scores compared to paracetamol by reducing postoperative opioid use in the first 24 h in patients undergoing LSG surgery.
Literature
1.
go back to reference Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab. 2004;89:2583–9.CrossRef Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab. 2004;89:2583–9.CrossRef
2.
go back to reference Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMed
3.
go back to reference Bisgaard T, Klarskow B, Kristiansen BV, et al. Multiregional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized double-blind placebo controlled study. Anesth Analg. 1999;89:1017–8.PubMed Bisgaard T, Klarskow B, Kristiansen BV, et al. Multiregional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized double-blind placebo controlled study. Anesth Analg. 1999;89:1017–8.PubMed
4.
go back to reference Cantore F, Boni L, Di Giuseppe M, et al. Pre-incisional local infiltration with levobupivacaine reduces pain and analgesic consumption after laparoscopic cholecystectomy: a new device for day-case procedure. Int J Surg. 2008;6:89–92.CrossRef Cantore F, Boni L, Di Giuseppe M, et al. Pre-incisional local infiltration with levobupivacaine reduces pain and analgesic consumption after laparoscopic cholecystectomy: a new device for day-case procedure. Int J Surg. 2008;6:89–92.CrossRef
5.
go back to reference Schug SA, Raymann A. Postoperative pain management of the obese patient. Best Pract Res Clin Anaesthesiol. 2011;25:73–81.CrossRefPubMed Schug SA, Raymann A. Postoperative pain management of the obese patient. Best Pract Res Clin Anaesthesiol. 2011;25:73–81.CrossRefPubMed
6.
go back to reference Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(2 Suppl l):S105.PubMed Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(2 Suppl l):S105.PubMed
7.
go back to reference Gallagher SF, Haines KL, Osterlund LG, et al. Postoperative hypoxemia: common, undetected, and unsuspected after bariatric surgery. J Surg Res. 2010;159:622–6.CrossRefPubMed Gallagher SF, Haines KL, Osterlund LG, et al. Postoperative hypoxemia: common, undetected, and unsuspected after bariatric surgery. J Surg Res. 2010;159:622–6.CrossRefPubMed
8.
go back to reference Block M, Jacobson LB, Rabkin RA. Heart block in patients after bariatric surgery accompanying sleep apnea. Obes Surg. 2001;11:627–30.CrossRefPubMed Block M, Jacobson LB, Rabkin RA. Heart block in patients after bariatric surgery accompanying sleep apnea. Obes Surg. 2001;11:627–30.CrossRefPubMed
9.
go back to reference Augestad KM, Delaney CP. Postoperative ileus: impact of pharmacological treatment, laparoscopic surgery and enhanced recovery pathways. World J Gastroenterol. 2010;16:2067–74.CrossRefPubMedPubMedCentral Augestad KM, Delaney CP. Postoperative ileus: impact of pharmacological treatment, laparoscopic surgery and enhanced recovery pathways. World J Gastroenterol. 2010;16:2067–74.CrossRefPubMedPubMedCentral
10.
go back to reference Moussa AA, Oregan PJ. Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgerydgranisetron alone vs granisetron combined with dexamethasone/droperidol. Middle East J Anesthesiol. 2007;19:357.PubMed Moussa AA, Oregan PJ. Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgerydgranisetron alone vs granisetron combined with dexamethasone/droperidol. Middle East J Anesthesiol. 2007;19:357.PubMed
11.
go back to reference American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an update report by the American Society of Anesthesiologist Task Force on acute pain management. Anesthesiology. 2012;116:248.CrossRef American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an update report by the American Society of Anesthesiologist Task Force on acute pain management. Anesthesiology. 2012;116:248.CrossRef
12.
go back to reference Svensson CI, Yaksh TL. The spinal phospholipase-cyclooxygenase-prostanoid cascade in nociceptive processing. Annu Rev Pharmacol Toxicol. 2002;42:553–83.CrossRefPubMed Svensson CI, Yaksh TL. The spinal phospholipase-cyclooxygenase-prostanoid cascade in nociceptive processing. Annu Rev Pharmacol Toxicol. 2002;42:553–83.CrossRefPubMed
13.
14.
go back to reference Martínez AG, Rodriguez BE, Roca AP, et al. Intravenous ibuprofen for treatment of post-operative pain: a multicenter, double blind, placebo-controlled, randomized clinical trial. PloS one. 2016;11(5):e0154004.CrossRef Martínez AG, Rodriguez BE, Roca AP, et al. Intravenous ibuprofen for treatment of post-operative pain: a multicenter, double blind, placebo-controlled, randomized clinical trial. PloS one. 2016;11(5):e0154004.CrossRef
15.
go back to reference Kroll PB, Meadows L, Rock A, et al. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen (IV-ibuprofen) in the management of postoperative pain following abdominal hysterectomy. Pain Pract. 2011;11:23–32.CrossRefPubMed Kroll PB, Meadows L, Rock A, et al. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen (IV-ibuprofen) in the management of postoperative pain following abdominal hysterectomy. Pain Pract. 2011;11:23–32.CrossRefPubMed
16.
go back to reference Singla N, Rock A, Pavliv L. A multi-center, randomized, double-blind placebo-controlled trial of intravenous-ibuprofen (IV-ibuprofen) for treatment of pain in post-operative orthopedic adult patients. Pain Med. 2010;11(8):1284–93.CrossRefPubMedPubMedCentral Singla N, Rock A, Pavliv L. A multi-center, randomized, double-blind placebo-controlled trial of intravenous-ibuprofen (IV-ibuprofen) for treatment of pain in post-operative orthopedic adult patients. Pain Med. 2010;11(8):1284–93.CrossRefPubMedPubMedCentral
17.
go back to reference Ahiskalioglu EO, MD AA, Aydin P, et al. Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine. 2017;96(8):e6200.CrossRefPubMedPubMedCentral Ahiskalioglu EO, MD AA, Aydin P, et al. Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine. 2017;96(8):e6200.CrossRefPubMedPubMedCentral
18.
go back to reference Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(Suppl 2):S105–20.PubMed Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(Suppl 2):S105–20.PubMed
19.
go back to reference Levi D, Goodman ER, Patel M, et al. Critical care of the obese and bariatric surgical patient. Crit Care Clin. 2003;19(1):11–32.CrossRefPubMed Levi D, Goodman ER, Patel M, et al. Critical care of the obese and bariatric surgical patient. Crit Care Clin. 2003;19(1):11–32.CrossRefPubMed
22.
go back to reference White PF. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Investig Drugs. 2008;9:76–82.PubMed White PF. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Investig Drugs. 2008;9:76–82.PubMed
23.
go back to reference American Society of Anesthesiologist Task Force. Practice guidelines for acute pain management in the perioperative setting. Anesthesiology. 2012;116:248–73.CrossRef American Society of Anesthesiologist Task Force. Practice guidelines for acute pain management in the perioperative setting. Anesthesiology. 2012;116:248–73.CrossRef
25.
go back to reference Song K, Melroy MJ, Whipple OC. Optimizing multimodal analgesia with intravenous acetaminophen and opioids in postoperative bariatric patients. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2014;34(S1):14S–21S.CrossRef Song K, Melroy MJ, Whipple OC. Optimizing multimodal analgesia with intravenous acetaminophen and opioids in postoperative bariatric patients. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2014;34(S1):14S–21S.CrossRef
26.
go back to reference Ng JJ et al. A multimodal analgesic protocol reduces opioid-related adverse events and improves patient outcomes in laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(12):3075–81.CrossRefPubMed Ng JJ et al. A multimodal analgesic protocol reduces opioid-related adverse events and improves patient outcomes in laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(12):3075–81.CrossRefPubMed
27.
go back to reference Gonzalez MA et al. Intravenous acetaminophen in bariatric surgery: effects on opioid requirements. J Surg Res. 2015;195(1):99–104.CrossRefPubMed Gonzalez MA et al. Intravenous acetaminophen in bariatric surgery: effects on opioid requirements. J Surg Res. 2015;195(1):99–104.CrossRefPubMed
28.
go back to reference Wininger SJ, Miller H, Minkowitz HS, et al. A randomized, double-blind, placebo-controlled, multicenter, repeat-dose study of two intravenous acetaminophen dosing regimens for the treatment of pain after abdominal laparoscopic surgery. Clin Ther. 2010;32(14):2348–69.CrossRefPubMed Wininger SJ, Miller H, Minkowitz HS, et al. A randomized, double-blind, placebo-controlled, multicenter, repeat-dose study of two intravenous acetaminophen dosing regimens for the treatment of pain after abdominal laparoscopic surgery. Clin Ther. 2010;32(14):2348–69.CrossRefPubMed
29.
go back to reference Bebenista MJ, Paracetamol NJZ. Mechanism of action, applications and safety concern. Acta Pol Pharm Drug Res. 2014;71(1):11–23. Bebenista MJ, Paracetamol NJZ. Mechanism of action, applications and safety concern. Acta Pol Pharm Drug Res. 2014;71(1):11–23.
30.
go back to reference Moore RA, Derry S, Wiffen PJ, et al. Overview review: comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain. 2015;19:1213–23.CrossRefPubMed Moore RA, Derry S, Wiffen PJ, et al. Overview review: comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain. 2015;19:1213–23.CrossRefPubMed
31.
go back to reference Gazal G, Al-Samadani KH. Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations. Saudi Med J. 2017;38:284–91.CrossRefPubMedPubMedCentral Gazal G, Al-Samadani KH. Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations. Saudi Med J. 2017;38:284–91.CrossRefPubMedPubMedCentral
33.
go back to reference Gozeler MS, Sakat MS, Kilic K, et al. Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty? Am J Otolaryngol. 2018;39:726–30.CrossRefPubMed Gozeler MS, Sakat MS, Kilic K, et al. Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty? Am J Otolaryngol. 2018;39:726–30.CrossRefPubMed
Metadata
Title
Comparison of Intravenous Ibuprofen and Paracetamol for Postoperative Pain Management after Laparoscopic Sleeve Gastrectomy. A Randomized Controlled Study
Authors
Bahadır Ciftci
Mursel Ekinci
Erkan Cem Celik
Ahmet Kaciroglu
Muhammet Ahmet Karakaya
Yavuz Demiraran
Yasar Ozdenkaya
Publication date
01-03-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3613-1

Other articles of this Issue 3/2019

Obesity Surgery 3/2019 Go to the issue