Preventive efficacy of ibuprofen and dexamethasone combination for postoperative pain in posterior vertebral stabilization: a randomized controlled study

Abstract

Background: Posterior vertebral stabilization procedures often cause acute postoperative pain that can turn into chronic pain if not managed adequately. We compared the interleukin 6 (IL-6) level and pain intensity with preventive use of multimodal analgesia with different combinations of intravenous ibuprofen and dexamethasone in these patients.
 Methodology: Thirty-nine eligible patients were randomized to receive intravenous ibuprofen 400 mg and dexamethasone 10 mg (Group A), ibuprofen 800 mg and dexamethasone 10 mg (Group B), and ibuprofen 800 mg alone (Group C). The study drugs were injected 30 min before surgical procedure followed by fentanyl 24 h postop in a single‑blinded fashion. Serum levels of IL-6 were measured with ELISA. and pain intensity was measured using numeric rating scale (NRS) at preop, then at 2 h and 24 h postoperatively.
 Results: There was a significant difference in the NRS scores between all treatment groups (P < 0.005) at all measurement times, where Group B had the lowest value. There was a significant difference between IL-6 levels between all treatment groups (P < 0.005) at all measurement times, where Group B had the lowest value at all measurement times. No side effects were observed in all treatment groups.
 Conclusion: Preventive combination of ibuprofen and dexamethasone has efficacy and safety in managing acute postoperative pain in posterior vertebral stabilization procedures.
 Abbreviations: COX – Cyclooxygenase; IL-6 - Interleukin 6; MAC - Minimum Alveolar Concentration; NRS - Numeric Rating Scale; NSAIDs - Non-Steroidal Anti-Inflammatory Drugs; PSA - Patient-Controlled Analgesia
 Key words: Analgesia; Dexamethasone; Ibuprofen; Interleukin-6; Preventive Medicines; Spinal Surgery
 Citation: Gaus S, Darise SA, Ala AA, Ahmad MR, Musba AT, Tan CW. Preventive efficacy of ibuprofen and dexamethasone combination for postoperative pain in posterior vertebral stabilization: a randomized controlled study. Anaesth. pain intensive care 2023;27(5):548−554; DOI: 10.35975/apic.v27i5.1851
 Received: March 22, 2023; Reviewed: August 26, 2023; Accepted: September 04, 2023