Ibuprofen, acetaminophen may provide effective pain management after carpal tunnel release
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Results presented at the American Society for Surgery of the Hand Annual Meeting showed use of ibuprofen and acetaminophen may be as effective as opioids in managing pain after carpal tunnel release.
Donald H. LaLonde, MD, FRCSC, and colleagues randomly assigned 347 patients undergoing carpal tunnel release at five centers in the United States and Canada to receive either 5 mg of hydrocodone with 325 mg of acetaminophen or 600 mg of ibuprofen with 325 mg of acetaminophen. Researchers considered the numeric pain rating scale (NPRS) and Patient-Reported Outcome Measurement Information System (PROMIS) pain interference T scores as the primary outcome measures, while total medications used and overall satisfaction with pain medication management were considered the secondary outcome measures.
LaLonde noted patients in the narcotic and non-narcotic groups had no significant differences in PROMIS T scores or NPRS scores. He added there was also no statistically significant difference in NPRS score between Canadian and American patients.
“Although, interestingly, there was a small non-significant difference where narcotic patients complained more of pain than non-narcotic patients, and Canadian patients complained more of pain than American patients in both narcotic and over-the-counter groups,” LaLonde said in his presentation.
Patients in the narcotic and non-narcotic groups had no statistically significant differences in the number of doses of medication or patient satisfaction, according to LaLonde. He noted the highest NPRS score difference occurred the night of surgery, with patients in the narcotic group reporting more pain compared with patients in the non-narcotic group. However, LaLonde said this difference was not statistically significant.
“The highest group difference in PROMIS Pain T scores was also the night of surgery, when the opiate patients had more pain interference than the over-the-counter pain medication group, but again, not statistically significant and no statistically significant pain score differences between Americans and Canadians,” LaLonde said.
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LaLonde DH, et al. Paper 39. Presented at: American Society for Surgery of the Hand Annual Meeting. Sept. 30 - Oct. 2, 2021; San Francisco (hybrid meeting).
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