The Safety and Efficacy of Ibuprofen in Acute Burn Pain Management—A Scoping Review

Background: While ibuprofen is a widely used non-opioid analgesic with growing evidence in surgical settings, its safety and efficacy in acute burn care remain poorly characterized. This review aims to address this gap. Methods: A systematic search was conducted in accordance with PRISMA-ScR (September 2025) across PubMed, MEDLINE, CENTRAL, CINAHL, and Scopus for original, English-language studies evaluating the safety and/or efficacy of ibuprofen, distinguishable from multimodal regimens, for acute burn analgesia. Results: Of 136 studies, six met inclusion criteria (5 adult, 1 pediatric). Populations primarily consisted of second- and third-degree burns; only two studies included >10% total body surface area (TBSA). Study designs were heterogeneous, all with moderate to high risk of bias, including one retrospective study (oral ibuprofen), two experimental double-blind placebo randomized controlled trials (RCTs) (topical; oral), and three clinical RCTs (intravenous; topical; topical and oral). No study reported associations with increased adverse events; a retrospective study found no increased bleeding risk with perioperative ibuprofen in skin graft patients. Analgesic outcomes were not directly comparable across studies due to heterogeneity. Experimental models found that ibuprofen did not reduce acute burn pain, but attenuated pain within hyperalgesic skin. Among clinical studies, both oral and dressing ibuprofen formulations demonstrated reduced procedural pain. One topical study noted faster wound healing, though this was confounded by less frequent dressing changes. Conclusions: The available studies were insufficient to draw definitive conclusions, limited by sample size, heterogeneity, bias, and exclusion of high-risk patients. Nonetheless, no study reported increased adverse events across diverse ibuprofen protocols. These findings underscore the need for adequately powered, agent-specific trials in clinically representative burn populations to inform evidence-based multimodal compositions amidst growing advocacy for opioid-sparing analgesia.