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Ibuprofen is beneficial for reducing
pain levels and opioid needs in individuals undergoing arthroscopic surgery.
In people undergoing primary arthroscopic rotator cuff surgery, postsurgery ibuprofen use decreases opioid needs and improves patient pain levels in the 1st week following surgery. Furthermore, ibuprofen usage after rotator cuff repair does not raise the risk of tendon retear, as deciphered from a randomized, placebo-controlled, double-blind trial published in The Journal of Shoulder and Elbow Surgery.
Researchers undertook this study for exploring the effects of postsurgery nonsteroidal anti-inflammatory drugs (NSAID) usage on opioid use, pain alleviation, and shoulder outcomes following arthroscopic rotator cuff repair. In this study, the enrolled participants were randomly allocated to receive either ibuprofen (n=51) or placebo (n=50) for two weeks postoperatively, plus opioid medications.
Participants were given instructions for keeping a daily pain diary for the 1st week after surgery that was returned at their initial postsurgery visit for evaluation. Collection of American Shoulder and Elbow Surgeons (ASES) scores, visual analog scale (VAS) scores, shoulder range of motion, 12-item Short Form Survey, and Disabilities of the Hand, Arm, and Shoulder was done. With the aid of ultrasound, evaluation of rotator cuff healing was done one year after surgery.
No inter-group differences were noted in terms of sex, age, race, history of preoperative or opioid or NSAID use, or operative findings. Compared to placebo recipients, the amount of mean total morphine milligram equivalents (MMEs) utilized in the 1st postsurgery week was reduced in ibuprofen recipients. At six months, the ibuprofen recipients showed greater mean forward flexion and the mean ASES score when compared to the placebo recipients, as shown in Table 1:
On postsurgery days 3, 4, 5, and 6, the ibuprofen group showed reduced early VAS scores. However, no inter-group differences were witnessed in mean VAS scores by six weeks following surgery. At one year, no differences were noted in the 12-item Short Form Survey, shoulder range of motion, ASES scores, and Disabilities of the Hand, Arm, and Shoulder.
The authors observed that at one
year postsurgery, seven people in ibuprofen arm reported tendon retear
diagnosed on ultrasound (five partial and two full thickness) when compared to
13 people in the placebo arm (five partial and eight full thickness). However,
this difference was not significant. Thus, ibuprofen yields satisfactory
outcomes in arthroscopic surgery.
The Journal of Shoulder and Elbow Surgery
The effects of nonsteroidal anti-inflammatory medications after rotator cuff surgery: a randomized, double-blind, placebo-controlled trial
Jennifer Tangtiphaiboontana et al.
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