No analgesic effect of ibuprofen or paracetamol vs placebo for hysterectomies

The aim of the present study was to evaluate the postoperative opioid-sparing effect of a pre-operative nonsteroidal anti-inflammatory drug (NSAID) (ibuprofen) vs paracetamol in a prospective, double-blind, placebo-controlled study. It was also investigated whether the use of ibuprofen or paracetamol would influence the amount of surgical bleeding. Sixty-six women scheduled for elective open hysterectomy were randomized into one of three groups. All patients received premedication (diazepam 10 mg) and test drugs orally 1 h before the start of anaesthesia: Group 1 (n=23) received 800 mg ibuprofen; Group 2 (n=22) received 1000 mg paracetamol; and Group 3 (n=21) received placebo. General anaesthesia was given with thiopentone-fentanyl-atracurium induction, and maintained with nitrous oxide-isoflurane. Postoperatively, the patients were evaluated hourly during the recovery period, and 1 and 4 days after the procedure. Postoperative pain was measured by visual analogue scale (VAS), verbal pain score and the need of standardized opioid rescue medication. Intra-operative bleeding was measured, as well as reduction in blood haemoglobin content 24 h and 4 days after the procedure. No differences were found between the groups in postoperative pain measured by any variable or opioid consumption at any time. The amount of surgical bleeding was equal in the three groups. Ibuprofen or paracetamol given pre-operatively to hysterectomy patients do not have a postoperative analgesic or opioid-sparing effect. Perioperative surgical bleeding is not influenced by these drugs.