Using Intravenous Ibuprofen for Preventive Analgesia in Orthognathic Surgery

Abstract

Preventive analgesia aims to manage postoperative pain caused by nociceptive and central stimulation. The purpose of this study was to research the effect of a single-dose intravenous (IV) ibuprofen administration for preventive analgesia on postoperative pain management in orthognathic surgery. This prospective, double blind, and randomized study was performed on a total of 40 adult patients who planned to undergo bimaxillary osteotomy, between 2018 and 2019. Thirty minutes before the surgery, 800mg of IV ibuprofen and 100mL of saline were applied to group 1 (ibuprofen; n=20) and group 2 (placebo; n=20), respectively. Postoperative analgesia was maintained with tramadol infusion via a patient-controlled analgesia pump. Postoperative visual analog scale (VAS) scores at 1, 3, 6, 9, 12, and 24hours after surgery, rescue analgesic requirement, total tramadol dose, and adverse effects were recorded. VAS scores between the groups at 1, 6, 9, and 24 hours and also the average of 24-hour VAS scores were similar (P>.05). However, VAS scores at 3hours were significantly higher in group 2 (P=0.06). Also, rescue analgesic intake of paracetamol was significantly higher in group 2 in the third hour (P=.08). Rescue analgesic intake of paracetamol and tramadol consumption during the postoperative 24hours were similar (P>.05). Using single-dose IV ibuprofen administration just before orthognathic surgery for preventive analgesia reduced VAS scores and postoperative opioid consumption in patients. However, further studies in a large population are needed to estimate the preventive analgesia effect of ibuprofen in orthognathic surgery.