COMPARATIVE EFFICACY OF ORAL IBUPROFEN ARGININE AND INTRAMUSCULAR KETOROLAC IN PATIENTS WITH POSTCESAREAN SECTION PAIN

In this double-blind double-dummy placebo-controlled study, 92 patient s from a single centre were randomly assigned to receive either ibupro fen arginine 400mg orally, ketorolac 30mg by intramuscular injection, or placebo, after caesarean section. Pain intensity was measured on a Visual Analogue Scale (VAS) ranging from 0 (no pain) to 100mm (unbeara ble pain) at 15, 30, 45, 60, 90, 120, 180, 240, 300, and 360 minutes a fter the administration of study medication. Pain intensity was reduce d in both active treatment groups from mean levels of 78mm (ibuprofen arginine treatment group) and 81mm (ketorolac group) to 47 and 48mm, r espectively, stabilising at less than or equal to 50mm after the first hour. In contrast, pain levels in the placebo group (78mm) were reduc ed to 63mm within the first hour after medication administration, then climbed slightly to stabilise at a mean level of approximately 69mm o n the VAS. Statistically significant differences were observed between active treatment groups and placebo, but not between the ketorolac an d ibuprofen arginine treatment groups. 47% of patients in the ibuprofe n arginine treatment group rated their medication as good Or better, c ompared with 53% of ketorolac recipients and 12% of placebo recipients . 66% of patients receiving placebo required rescue medication, compar ed with 43% and 37% of patients receiving ibuprofen arginine and ketor olac, respectively. No adverse effects were reported. These findings s uggest that oral administration of ibuprofen arginine may prove to be a useful alternative to parenteral administration of analgesic agents in the immediate postoperative period after caesarean section.