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Ibuprofen vs. acetaminophen vs. ibuprofen and acetaminophen after arthroscopically assisted anterior cruciate ligament reconstruction

Published online by Cambridge University Press:  23 December 2004

V. Dahl ,
T. Dybvik ,
T. Steen ,
A. K. Aune ,
E. K. Rosenlund  and
J. C. Ræder
V. Dahl
Affiliation:
Volvat Medical Centre, Department of Anesthesia, Oslo, Norway
T. Dybvik
Affiliation:
Volvat Medical Centre, Department of Anesthesia, Oslo, Norway
T. Steen
Affiliation:
Volvat Medical Centre, Department of Orthopedic Surgery, Oslo, Norway
A. K. Aune
Affiliation:
Volvat Medical Centre, Department of Orthopedic Surgery, Oslo, Norway
E. K. Rosenlund
Affiliation:
Volvat Medical Centre, Department of Orthopedic Surgery, Oslo, Norway
J. C. Ræder
Affiliation:
Volvat Medical Centre, Department of Anesthesia, Oslo, Norway
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Abstract

Summary

Background and objective: The analgesic potency of non-steroidal anti-inflammatory drugs and acetaminophen are still being debated. We have assessed the relative analgesic effect of ibuprofen, acetaminophen or the combination of both after orthopaedic surgery.

Methods: Sixty-one ASA I patients, scheduled for an elective anterior cruciate ligament reconstruction under general anaesthesia were randomized, in a double blind fashion, into one of three groups. The ibuprofen group (n = 17) received ibuprofen 800 mg orally 1 h before operation and again at 6 and 12 h after the initial dose. The acetaminophen group (n = 20) received of acetaminophen 1 g orally at the same time intervals. The combination group (n = 24) received both ibuprofen 800 mg and acetaminophen 1 g. Surgery was performed under general anaesthesia with propofol and fentanyl for induction and maintenance with propofol and nitrous oxide in oxygen. The patients were monitored for 24 h thereafter, and the following variables were assessed: pain by visual analogue and verbal scales, need for rescue intravenous opioid analgesia (i.e. ketobemidone) and adverse events.

Results: The ibuprofen group and the combination group experienced significantly less pain during the first 6 h after surgery than the acetaminophen group using the visual analogue and the verbal scales. The acetaminophen group also had a significantly higher average consumption of opioids during the first 6 and 24 h. There were no significant differences between the ibuprofen group and the combination group in respect of experienced pain or consumption of rescue analgesia. The incidence of side-effects, postoperative haemoglobin concentration and renal function, judged by creatinine clearance, were identical between the groups.

Conclusion: Ibuprofen 800 mg thrice daily reduced pain to a greater degree than acetaminophen 1 g thrice daily, after anterior cruciate ligament reconstruction under general anaesthesia. The combination of acetaminophen and ibuprofen did not provide any superior analgesic effect.

Keywords

ANALGESICS, NON-NARCOTIC, acetaminophenANALGESICS, NON-NARCOTIC, anti-inflammatory agents, non-steroidal, ibuprofenENZYME INHIBITORS, cyclo-oxygenase inhibitorsPAIN, pain, postoperative
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 6 , June 2004 , pp. 471 - 475
Copyright
2004 European Society of Anaesthesiology

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