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 Sep;275(9):2259-2263. doi: 10.1007/s00405-018-5065-6. Epub 2018 Jul 18.

Abstract

Purpose: Septorhinoplasty is performed in combination with septoplasty and rhinoplasty operations and is characterized by severe postoperative pain. The aim of this study is to evaluate preemptive effects of intravenous (IV) ibuprofen and IV paracetamol on opioid consumption and pain scores after open septorhinoplasty.

Methods: The study included 150 patients who had undergone elective open septorhinoplasty. Patients were randomly assigned into three groups; Group Control (Group C, n = 50) received 100 ml saline solution, Group Paracetamol (Group P, n = 50) received 1000 mg IV paracetamol in 100 ml solution, and Group Ibuprofen (Group I, n = 50) received 800 mg IV ibuprofen in 100 ml saline before surgery. Postoperative analgesia was achieved by opioid administration via patient-controlled analgesia. Visual analog scores (VASs), postoperative opioid consumption, additional analgesic requirements, and side effects were recorded.

Results: Compared with Group C, VASs in Group P and Group I were statistically lower at all time points (p < 0.05). VAS was lower in Group I than in Group P at postoperative, 1st and 6th hours (p < 0.05). Opioid consumption in Group C was highest in all groups at all time periods (p < 0.05). At the 0-6 and 6-12 time intervals, total opioid consumption was significantly lower in Group I compared to Group P (p < 0.05). Total opioid consumption was highest in Group C (p < 0.05).

Conclusions: This study has indicated that ibuprofen has more analgesic effect than paracetamol during first 12 h, but there is a non-inferiority between ibuprofen and paracetamol after first 12 h.

Keywords: Analgesia; Anesthesia; Ibuprofen; Paracetamol; Septorhinoplasty.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / therapeutic use*
  • Administration, Intravenous
  • Adult
  • Analgesia, Patient-Controlled
  • Analgesics / therapeutic use*
  • Analgesics, Opioid / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Ibuprofen / therapeutic use*
  • Male
  • Middle Aged
  • Nasal Septum / surgery*
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Rhinoplasty / adverse effects*
  • Young Adult

Substances

  • Analgesics
  • Analgesics, Opioid
  • Acetaminophen
  • Ibuprofen