Comparative Efficacy of Oral Ibuprofen Arginine and Intramuscular Ketorolac in Patients with Postcaesarean Section Pain
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In this double-blind double-dummy placebo-controlled study. 92 patients from a single centre were randomly assigned to receive either ibuprofen arginine 400mg orally, ketorolac 30mg by intramuscular injection, or placebo, after caesarean section. Pain intensity was measured on a Visual Analogue Scale (VAS) ranging from 0 (no pain) to 100mm (unbearable pain) at 15, 30, 45, 60. 90, 120, 180, 240, 300, and 360 minutes after the administration of study medication.
Pain intensity was reduced in both active treatment groups from mean levels of 78mm (ibuprofen arginine treatment group) and 81mm (ketorolac group) to 47 and 48mm, respectively, stabilising at ≤ 50mm after the first hour. In contrast, pain levels in the placebo group (78mm) were reduced to 63mm within the first hour after medication administration, then climbed slightly to stabilise at a mean level of approximately 69mm on the VAS. Statistically significant differences were observed between active treatment groups and placebo, but not between the ketorolac and ibuprofen arginine treatment groups.
47% of patients in the ibuprofen arginine treatment group rated their medication as good or better, compared with 53% of ketorolac recipients and 12% of placebo recipients. 66% of patients receiving placebo required rescue medication, compared with 43% and 37% of patients receiving ibuprofen arginine and ketorolac, respectively. No adverse effects were reported.
These findings suggest that oral administration of ibuprofen arginine may prove to be a useful alternative to parenteral administration of analgesic agents in the immediate postoperative period after caesarean section.
KeywordsVisual Analogue Scale Caesarean Section Ibuprofen Pain Intensity Visual Analogue Scale Score
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