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Ibuprofen not associated with increased bleeding risk in plastic surgery
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Ibuprofen provided pain control and did not significantly increase the risk for bleeding in patients undergoing plastic surgery, according to recently published results in Plastic and Reconstructive Surgery.
Researchers conducted a literature review of 881 primary research articles on ibuprofen and bleeding using Medline, Embase and the Cochrane Collaboration Library.
Primary journal articles examining treatment of acute postoperative pain based on any modality were inclusion criteria. The researchers conducted bias assessment and meta-analysis.
The full analysis included four primary randomized control trials, with articles of high quality by bias assessment
Patients undergoing operations with general anesthesia were included in two studies, while the type of anesthesia was not mentioned in the other two studies. Plastic surgery operations performed included facial aesthetic surgery, breast surgery, inguinal herniorrhaphy and cutaneous reconstructive procedures following Mohs surgery.
Ibuprofen administration began before incision in a single study, while it was administered after surgery in the other studies. The dosage of ibuprofen was 400 mg orally every 4 hours in all studies. There was a standardized 100-mm visual analogue scale used to discuss pain management in all four studies.
The researchers found no significant difference in bleeding events with ibuprofen, and pain control was equivalent.
“Ibuprofen appears to be equivalent for treatment of postoperative pain compared with tramadol,” the researchers wrote.
“Ibuprofen is a useful medication in surgical patients, with multiple beneficial effects,” the researchers concluded. “Furthermore, avoidance of ibuprofen and other nonsteroidal anti-inflammatory drugs may lead to increased narcotic consumption or more difficult postoperative pain control. Ibuprofen may be of the most benefit in the immediate post-operative period starting on the day of surgery to achieve adequate, early pain control. – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.
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