Document Type : Research articles
Authors
- Hossein Shaker 1
- Mohammad Hossein Rezaei 2
- Hamed Basir Ghafouri 1
- Niloofar Abazarian 3
- Ehsan Modirian 4
1 Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran.
2 Emergency Medicine Department, Iran University of Medical Sciences, Tehran, Iran.
3 School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
4 Emergency Department, Qazvin University of Medical Sciences, Qazvin, Iran.
Abstract
Background: Wound repair cause extra pain and inflammation and can lead to post-repair discomfort in patients. Previous studies have indicated that pre-operative use of NSAIDs may reduce post-surgery pain; however, there is a dearth of data on traumatic wound repair.
Objectives: This study aimed to investigate the effect of intravenous Ibuprofen on patient satisfaction and pain relief following wound repair.
Methods: Based on the inclusion and exclusion criteria, 194 participants in this double-blind randomized controlled trial were randomly assigned to either intervention or control group. Ibuprofen 800 mg was infused in 100 cc normal saline before wound repair in the intervention group, while the control group received 100 cc normal saline. Numeric pain scores were recorded at the beginning of wound repair and 30 min after that. Patients satisfaction with analgesia was also recorded 15 min after the drug infusion, during wound repair, and 6 h after the wound repair.
Results: Mean pain scores were similar in both groups during the wound repair, and before the application of local anesthesia (i.e. lidocaine). However, the mean pain score was significantly lower in patients who received Ibuprofen (3.86±1.93), compared to the control group (4.46±1.89), 30 min after the wound repair (P=0.043). Patients satisfaction with pain management 6 h after the wound repair was higher in the intervention (P=0.000), compared to the control group.
Conclusion: Based on the obtained results, the application of IV Ibuprofen before the wound repair can reduce pain score after the wound repair and lead to improved patients'
Keywords
- Rui P, Kang K, Ashman JJ. National hospital ambulatory medical care survey: 2016 emergency department summary tables. 2016. Atlanta, GA: Centers for Disease Control and Prevention; 2017.
- Singer AJ, Mach C, Thode HC Jr, Hemachandra S, Shofer FS, Hollander JE. Patient priorities with traumatic lacerations. Am J Emerg Med. 2000;18(6):683-6. doi: 10.1053/ajem.2000.16312. [PubMed: 11043622].
- Prevaldi C, Paolillo C, Locatelli C, Ricci G, Catena F, Ansaloni L, et al. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES). World J Emerg Surg. 2016;11:30. doi: 10.1186/s13017-016-0084-3. [PubMed: 27330546].
- Nicks BA, Ayello EA, Woo K, Nitzki-George D, Sibbald RG. Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations. Int J Emerg Med. 2010;3(4):399-407. doi: 10.1007/s12245-010-0217-5. [PubMed: 21373312].
- De Buck F, Devroe S, Missant C, Van de Velde M. Regional anesthesia outside the operating room: indications and techniques. Curr Opin Anaesthesiol. 2012;25(4):501-7. doi: 10.1097/ACO.0b013e3283556f58. [PubMed: 22673788].
- Davies RJ. Buffering the pain of local anaesthetics: a systematic review. Emerg Med (Fremantle). 2003;15(1):81-8. doi: 10.1046/j.1442-2026.2003.00413.x. [PubMed: 12656792].
- Singer AJ, Hollander JE, Quinn JV. Evaluation and management of traumatic lacerations. N Engl J Med. 1997;337(16):1142-8. doi: 10.1056/NEJM199710163371607. [PubMed: 9329936].
- Zempsky WT, Cravero JP; American Academy of Pediatrics Committee on Pediatric Emergency Medicine and Section on Anesthesiology and Pain Medicine. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004;114(5):1348-56. doi: 10.1542/peds.2004-1752. [PubMed: 15520120].
- Livingston A. Mechanism of action of nonsteroidal anti-inflammatory drugs. Vet Clin North Am Small Anim Pract. 2000;30(4):773-81. doi: 10.1016/s0195-5616(08)70006-8. [PubMed: 10932824].
- Díaz-González F, Sánchez-Madrid F. NSAIDs: learning new tricks from old drugs. Eur J Immunol. 2015;45(3):679-86. doi: 10.1002/eji.201445222. [PubMed: 25523026].
- Michelet D, Andreu-Gallien J, Bensalah T, Hilly J, Wood C, Nivoche Y, et al. A meta-analysis of the use of nonsteroidal antiinflammatory drugs for pediatric postoperative pain. Anesth Analg. 2012;114(2):393-406. doi: 10.1213/ANE.0b013e31823d0b45. [PubMed: 22104069].
- Costa FW, Esses DF, de Barros Silva PG, Carvalho FS, Sá CD, Albuquerque AF, et al. Does the preemptive use of oral nonsteroidal anti-inflammatory drugs reduce postoperative pain in surgical removal of third molars? A meta-analysis of randomized clinical trials. Anesth Prog. 2015;62(2):57-63. doi: 10.2344/0003-3006-62.2.57. [PubMed: 26061574].
- De Oliveira GS Jr, Agarwal D, Benzon HT. Perioperative single dose ketorolac to prevent postoperative pain: a meta-analysis of randomized trials. Anesth Analg. 2012;114(2):424-33. doi: 10.1213/ANE.0b013e3182334d68. [PubMed: 21965355].
- Nir RR, Nahman-Averbuch H, Moont R, Sprecher E, Yarnitsky D. Preoperative preemptive drug administration for acute postoperative pain: a systematic review and meta-analysis. Eur J Pain. 2016;20(7):1025-43. doi: 10.1002/ejp.842. [PubMed: 26991963].
- Bushra R, Aslam N. An overview of clinical pharmacology of Ibuprofen. Oman Med J. 2010;25(3):155-661. doi: 10.5001/omj.2010.49. [PubMed: 22043330].
- Bookstaver PB, Miller AD, Rudisill CN, Norris LB. Intravenous ibuprofen: the first injectable product for the treatment of pain and fever. J Pain Res. 2010;3:67-79. doi: 10.2147/jpr.s6993. [PubMed: 21197311].
- 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. doi: 10.1111/j.1526-4637.2010.00896.x. [PubMed: 20609131].
- Pınar HU, Karaca Ö, Karakoç F, Doğan R. Effects of addition of preoperative intravenous ibuprofen to pregabalin on postoperative pain in posterior lumbar interbody fusion surgery. Pain Res Manag. 2017;2017:1030491. doi: 10.1155/2017/1030491. [PubMed: 28951663].
- Moss JR, Watcha MF, Bendel LP, McCarthy DL, Witham SL, Glover CD. A multicenter, randomized, double-blind placebo-controlled, single dose trial of the safety and efficacy of intravenous ibuprofen for treatment of pain in pediatric patients undergoing tonsillectomy. Paediatr Anaesth. 2014;24(5):483-9. doi: 10.1111/pan.12381. [PubMed: 24646068].
- Çelik EC, Kara D, Koc E, Yayik AM. 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;275(9):2259-63. doi: 10.1007/s00405-018-5065-6. [PubMed: 30022362].
- Ahiskalioglu EO, Ahiskalioglu A, Aydin P, Yayik AM, Temiz A. Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy. Medicine (Baltimore). 2017;96(8):e6200. doi: 10.1097/MD.0000000000006200. [PubMed: 28225506].
- Kokki H, Kumpulainen E, Lehtonen M, Laisalmi M, Heikkinen M, Savolainen J, et al. Cerebrospinal fluid distribution of ibuprofen after intravenous administration in children. Pediatrics. 2007;120(4):e1002-8. doi: 10.1542/peds.2007-0064. [PubMed: 17908721].
- Smith HS, Voss B. Pharmacokinetics of intravenous ibuprofen: implications of time of infusion in the treatment of pain and fever. Drugs. 2012;72(3):327-37. doi: 10.2165/11599230-000000000-00000. [PubMed: 22316349].
', './data/ircmj/coversheet/cover_en.jpg'))