Postoperative Pain Management Clinical Trial
Official title:
Efficacy of Intravenous Ibuprofen and Paracetamol on Postoperative Pain and Morphine Consumption in Lumbar Disc Surgery: Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Primary aim of this prospective, randomized, double-blind, placebo-controlled clinical trial is to compare the analgesic effects of IV ibuprofen and paracetamol on postoperative pain, and secondary aim is the effects on morphine consumption and side effects of morphine in patients who underwent lumbar disc surgery with a single level laminectomy or discectomy.
All surgical procedures are associated with acute pain and inflammation, with varying degrees
of severity for patients, causing significant stress and discomfort. Effective postoperative
pain management in lumbar disc surgery may reduce complications and improve postoperative
care. For postoperative pain, multimodal analgesic techniques are used to provide synergistic
effects through different nociceptive mechanisms.
Various analgesics are used for pain. Opioids, commonly used for postoperative pain, are the
most popular drug group. Side effects such as sedation, respiratory depression,
nausea-vomiting, pruritus and urinary retention that develop secondary to opioids may also be
reduced by the combination of supplemental analgesics.
Adjuvant agents, including nonsteroidal anti-inflammatory drugs (NSAID), may be used in
combination with opioids. These drugs not only reduce pain but also control the underlying
inflammatory process. In addition, combining NSAIDs and opioids can help to reduce the side
effects by minimizing administration of total opioid consumption.
Intravenous (IV) ibuprofen is the first and only IV NSAID approved in the United States for
both pain and fever control in adults. It has been reported in multicenter studies that IV
ibuprofen is safe and effective in postoperative pain management for abdominal hysterectomy
and orthopedic surgeries.
IV paracetamol is an analgesic and antipyretic agent used as a first step drug for pain and
fever control in adults and children. It has been clearly shown that IV paracetamol, with
analgesic efficacy and good safety profile, reduces analgesic requirements for pain
management. It provides better analgesic efficacy and reduces opioid consumption when used in
combination with opioids.
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