SUSTAINED-RELEASE IBUPROFEN AS AN ADJUNCT TO MORPHINE PATIENT-CONTROLLED ANALGESIA

Previous studies have demonstrated reduced postoperative morphine requ irements and/or improved pain relief when nonsteroidal antiinflammator y drugs are administered in conjunction with patient-controlled analge sia (PCA). This double-blind study aimed to determine whether these ef fects could be obtained with a sustained-release ibuprofen formulation (Brufen Retard(R)) given preoperatively, obviating the need for oral administration during the early postoperative period. We aimed also to determine whether the anticipated reduction in morphine requirements was associated with reduced opioid side effects. One hundred fifteen p atients scheduled for lower abdominal gynecological surgery were rando mly assigned to receive either sustained-release ibuprofen, 2 x 800 mg (n = 57), or placebo (n = 58) preoperatively and again 24 h after the first dose. Arterial oxyhemoglobin saturation (SpO(2)) was monitored preoperatively and for 24 h postoperatively. Patients were assessed ev ery 4 h up to 24 h postoperatively. Those receiving ibuprofen reported significantly less pain at rest (P = 0.023) and less pain on movement , although the latter was not statistically significant (P = 0.951), P atients' opinions of the efficacy of their pain-relieving medication ( P < 0.001) and quality of sleep (P = 0.036) favored ibuprofen. Morphin e consumption was slightly but not significantly lower in the ibuprofe n group (32 vs 38 mg/24 h, P = 0.096). SpO(2) (P = 0.54), level of con sciousness (P = 0.65), and number of antiemetic administrations (P = 0 .15) did not differ significantly between groups. These results demons trate improved efficacy with no increase in side effects when sustaine d-release ibuprofen is used as an adjunct to morphine PCA.