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Effective postoperative pain management after laparoscopic cholecystectomy can minimize the need for rescue analgesics and facilitate recovery.
A single 400-mg preemptive intravenous dose of ibuprofen improves postoperative analgesia, prolongs time to first rescue analgesia, and reduces tramadol use after laparoscopic cholecystectomy.
Effective postoperative pain management after laparoscopic cholecystectomy can minimize the need for rescue analgesics and facilitate recovery. Preemptive analgesia, administered before surgical stimulation, may help control postoperative pain by hampering the development of pain sensitization. This study explored whether a single preoperative dose of intravenous (IV) ibuprofen could improve analgesic and hemodynamic outcomes.
This randomized controlled trial was conducted over 6 months at the Department of Anesthesia, Civil Hospital Karachi. It included 110 volunteers aged 40–80 years with American Society of Anesthesiologists (ASA) physical status I–II who were undergoing elective laparoscopic cholecystectomy. Subjects were randomly allocated to two groups of 55 patients each:
Hemodynamic parameters—including mean arterial pressure (MAP), heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP)—were assessed 30 minutes postoperatively. Postoperative pain was determined via the visual analog scale (VAS), while the time to first analgesic requirement and rescue tramadol consumption were recorded.
Preemptive administration of IV ibuprofen demonstrated noticeable improvements in postoperative hemodynamics, duration of analgesia, and total rescue opioid requirements (Table 1).
Preemptive use of single-dose IV ibuprofen (400 mg) prior to general anesthesia induction for laparoscopic cholecystectomy significantly enhanced postoperative pain management. It substantially delayed the need for first rescue analgesia, reduced overall opioid requirements, and stabilized early postoperative hemodynamic parameters. Thus, integrating it into perioperative multimodal analgesic protocols can optimize recovery pathways and minimize opioid-related adverse events.
CME Journal Geriatric Medicine
Comparison of the Outcome of Single-Dose Preemptive Intravenous Ibuprofen Versus Placebo in Patients Undergoing Laparoscopic Cholecystectomy at a Tertiary Care Hospital, Karachi
Pawan Kumar et al.
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