The effectiveness of intravenous ibuprofen versus intravenous ketorolac for postoperative pain relief after caesarean section

Abstract

Background Caesarean deliveries are currently the most frequent surgical procedure performed worldwide. Nonsteroidal anti-inflammatory drugs are frequently used to control postoperative pain as a part of the multimodal analgesia technique. We studied the efficacy of intravenous ibuprofen versus intravenous ketorolac to relieve postoperative pain following caesarean delivery under general anaesthesia. Patients and methods Fifty adult parturients aged 20–30 were studied and classified to the American Society of Anaesthesiologists (ASA) class II scheduled for elective caesarean delivery under general anaesthesia. Patients were divided into groups: group A (n=25), 30 mg ketorolac in 200 ml normal saline every 6 h, and group B (n=25), 800 mg ibuprofen in 200 ml normal saline every 6 h. They were evaluated for haemodynamic stability, visual analog score (VAS) score, 24-h opioid requirement, time to ambulate, and time to first analgesic dose. Results Group B (ibuprofen group) showed a lower VAS score through all the 24 h postoperatively at rest and during movement with allover VAS at rest (3.17±1.08) versus (4.32±1.3) P=0.008 and allover VAS during movement (3.21±1.11) versus (4.56±1.92) P=0.001. Also, lower 24-h opioid requirement in group B (ibuprofen group) with a mean value of (42.0 ±21.31) mg versus (110.0±17.68) mg in group A (ketorolac group) P=0.0021 and longer time to first analgesic dose in group B (ibuprofen group) with a mean value of (328.0±89.63) min versus (158.40 ±57.13) min in group A (ketorolac group) P=0.001 with more haemodynamic stability. Group B also showed lower ambulation time and less nocturnal awakening due to pain. Conclusions Intravenous ibuprofen is more effective than intravenous ketorolac in reducing postoperative pain following caesarean delivery. It reduces the 24-h opioid requirement and VAS at rest and during movement.