10. The use of intravenous ibuprofen in postoperative period
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Abstract
The article reflects the role of non-steroidal anti-inflammatory drugs in postoperative period. The study was conducted on the data of 94 operations of children aged from 10 months to 15 years (mean age 4.4 years). All patients of our center with esophagocoloplasty in the postoperative period received the drug «Intrafen» in injectable form, intravenously. Name of manufacturer of drug: GEN ILAC VE SAGLIK URUNLERI SANAYI VE TICARET, A. S. (Turkey). The main active substance of this drug is Ibuprofen 400mg/4ml for intravenous injection. Patients were injected intravenous ibuprofen at therapeutically effective doses for a minimal period of time. After receiving positive reactions to the drug at the initial stage of treatment, the dose and frequency of taking the drug was adjusted individually for each patient.
Objective. This work is dedicated to evaluate the role of the intravenous Ibuprofen in the postoperative period in surgical practice.
Material and methods. The study included 94 pediatric patients with esophagocoloplasty. Age of patients: from 10 months to 15 years (mean age 4.4 years), of which: 90 (96%) patients had post-burn stricture of the esophagus; 3 (3%) patients with esophageal atresia; 1 (1%) patient with a short esophagus. The number of female children - 51 (54.3%) patients, male - 43 (45.7%) patients.
Results. The total number of patients receiving intravenous Ibuprofen in the postoperative period was 94. The optimal dose showed a good therapeutic effect. At the optimal dosage of 20 mg/kg/day, two patients experienced intra-abdominal bleeding. Follow-up time: 2 weeks after esophagocoloplasty.
Conclusion. In patients with esophagocoloplasty, preventive intravenous administration of Ibuprofen showed a good therapeutic result. Patients noted a decrease in pain, which in turn led to a decrease in the need for emergency analgesia.
Keywords
intravenous ibuprofen, postoperative analgesia
References
- Indications for the use of intravenous Ibuprofen are pain syndrome of various etiologies, including postoperative pain; treatment of pain syndromes of moderate and severe intensity, as an adjunct to intravenous opioid analgesics. The use of intravenous ibuprofen reduces the undesirable side effects inherent in “morphine-like” analgesics, such as toxic effects on the central nervous system, respiratory depression, paresis of the gastrointestinal tract
- It is advisable to prescribe intravenous ibuprofen for three days after surgery, every 12 hours at a rate of 20 mg/kg/day in case of severe or moderate pain. The duration of intravenous drip should be at least 30 minutes. The highest recommended dose for children is 30 mg/kg/day
- To reduce the risk of side effects associated with the gastrointestinal tract, the dose of NSAIDs should be reduced to the minimum effective dose as soon as possible
- Derry S., Moore R., Rabbie R. Topical NSAIDs for chronic muscoloskeletal pain in adults. Cochrane Database Sys Rev., 2012, sep 12; 9 CD 007400
- Sostres C., Gargallo C., Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther, 2013, 15 (suppl 3), S3
- Souter A. Controversies in the perioperative use of nonsteroidal anti-inflammatory drugs. AnesthAnalg 1994; 79: 1178–1190
- Strom B., Berlin J., Kinman J., et al. Parenteral ketorolac and the risk of gastrointestinal and operative site bleeding. A postmarketing surveillance study. JAMA 1996; 275: 376–382
- Weber EW, Slappendel R, Durieux ME, et al. COX 2 selectivity of non-steroidal anti-inflammatory drugs and perioperative blood loss in hip surgery. A randomized comparison of indomethacin and meloxicam. Eur J Anaesthesiol. 2003 Dec;20(12):963-6
- Bricker S., Savage M., Hanning C. Perioperative blood loss and non-steroidal anti-inflammatory drugs: an investigation using diclofenac in patients undergoing transurethral resection of the prostate. Eur J Anaesthesiol 1987; 4: 429–434
- Wierod F., Frandsen N., Jacobsen J., et al. Risk of haemorrhage from transurethral prostatectomy in acetylsalicylic acid and NSAID-treated patients. Scand J UrolNephrol 1998; 321: 20–22
- Nikanne E., Kokki H., Salo J., Linna T. Celeco xib and ketoprofen for pain management during тtonsillectomy: a placebo-controlled clinical trial. Otolaryngol Head Neck Surg. 2005, 132, 287-294
- Møiniche S., Rømsing J., Dahl J., Tramèr M. Nonsteroidal antiinflammatory drugs and the risk ofoperative site bleeding after tonsillectomy: A quantitative systematic review. AnesthAnalg 2003; 96:68-77
- Kowalski ML, Asero R, Bavbek S, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy. 2013 Oct;68(10):1219-32. doi:10.1111/all.12260.Epub2013Oct5
- White AA, Stevenson DD. Aspirin-exacerbated respiratory disease: update on pathogenesis and desensitization. SeminRespirCrit Care Med. 2012 Dec;33(6):588-94. doi:10.1055/s-0032-1325618.Epub2012Oct9