Premedication with Intravenous Ibuprofen Improves Recovery Characteristics and Stress Response in Adults Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Le V, Kurnutala L, Schiano di Cola, Ahmed K, et al.
This prospective, randomized, controlled, double-blind, multicenter trial examined the effect of IV ibuprofen on surgical stress response.
Pre- and postoperative assessment included a global 40-item Quality of Recovery (QoR40) questionnaire and fatigue level along with blood samples to measure cortisol, C-reactive protein, cytokines, epinephrine, and norepinephrine.
The global QoR40 (40-item Quality of Recovery) questionnaire scores remained at baseline in the IV ibuprofen-treated patients versus the significant decrease (p < 0.001) observed in the placebo-treated patients on postoperative day (POD) 1. Similarly, fatigue, as measured by a 9-item Modified Fatigue Severity Scale (MFSS), was more severe in the placebo patients versus no change observed in the IV-ibuprofen patients at points measured postoperatively. Epinephrine and Norepinephrine levels in IV-ibuprofen patients were significantly reduced compared to placebo patients intraoperatively (p = 0.004) but not pre-operatively or in the post-anesthesia care unit (PACU). Cortisol levels between the two groups were significantly decreased postoperatively in IV-ibuprofen patients versus placebo patients (p = 0.001) in the PACU. There was no significant difference in C reactive protein (CRP) values between groups at any timepoint.