The Effect of Single-Dose Preemptive Intravenous Ibuprofen on the Intraoperative Hemodynamic Parameters, Recovery Characteristics, and Acute Pain after Laparoscopic Cholecystectomy: A Randomized Double-Blind, Placebo-Controlled Clinical Trial

Background/aims: The aim of this study was to investigate the effects of the preemptive administration of a single dose of intravenous (IV) ibuprofen on the intraoperative hemodynamic parameters, recovery characteristics, and postoperative pain management in patients undergoing laparoscopic cholecystectomy. The time to first analgesic requirement during postoperative period was the main goal of this study. Material and methods: Following ethical committee approval, sixty patients scheduled for laparoscopic cholecystectomy with American Society of Anesthesiologists (ASA) physical status I-II and aged 30-65 years of either genders were included in this prospective, randomized, placebo-controlled double blinded study. Patients were randomly divided into two groups. The study group (group I) received 400 mg ibuprofen in 100 ml IV saline 15 min before anesthesia induction, whereas the placebo group (group C) received IV 100 ml saline only. The study drug and the saline were administered by an anesthesia nurse blinded to the study. The same general anesthesia protocol was applied in both groups. Hemodynamic parameters (non-invasive systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure, heart rate (HR), bispectral index (BIS) values and SpO2 values were recorded before induction (baseline) and after induction, peroperative 10, 20, 30, minutes., before extubation. The time to achieve a modified Aldrete score of ≥ 9 was recorded as the recovery time. During postoperative period, the time to first analgesic requirement and the total amount of analgesics within 24 hours was recorded. Patients were asked to give a number between from 1 to 5 for the satisfaction assessment for the anesthesia management. Results: There was no difference between the groups in terms of hemodynamic findings before anesthesia induction and in the peroperative period. The time until Aldrete score of 9 was statistically significantly shorter in Group I (Group I 3.8 ± 1.4 min, and Group C 6.3 ± 1.9 min, p < 0.001). Sevoflurane consumption was lower in the group given preemptive single dose IV ibuprofen, but the time to first postoperative analgesic requirement was longer (p < 0.001). Total analgesic consumption was highest in Group C (p < 0.001). Conclusion: Preemptive single dose i.v. ibuprofen (400 mg) can be used in laparoscopic cholecystectomy with the advantages of reducing the consumption of peroperative sevoflurane, providing better VAS scores, shortening the time to the first postoperative analgesic requirement and reducing analgesic consumption.