Sparber LS, et al. – The efficacy of perioperative intravenous (IV) ibuprofen on postoperative pain level and narcotic use were assessed in patients undergoing open or laparoscopic inguinal and/or umbilical hernia repair. Among patients undergoing elective hernia repair, preoperative administration of IV ibuprofen did not significantly reduce postoperative pain. The authors noted considerable variability in postoperative narcotic analgesic requirement. To better understand the narcotic analgesic requirements associated with IV ibuprofen in inguinal/umbilical hernia repair patients, larger scale studies were needed.

Methods

• The authors performed a single center, randomized, double-blind placebo-controlled trial involving patients ≥18 years undergoing inguinal and/or umbilical hernia repair.
• They randomized patients to receive 800 mg of IV ibuprofen or placebo preoperatively.
• For this study, outcomes assessed included postoperative pain medication required and visual analog scale (VAS) pain scores.

Results

• A total of 48 adult male patients underwent inguinal and/or umbilical hernia repair.
• Compared to placebo (p=0.556), 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 the placebo group, 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, however, this was not statistically significant.
• The authors observed similar pain levels at 1, 3, and 7 days, postoperative and similar use of rescue medications in both groups.