PROPHYLACTIC ORAL IBUPROFEN OR IBUPROFEN-CODEINE VERSUS PLACEBO FOR POSTOPERATIVE PAIN AFTER PRIMARY HIP-ARTHROPLASTY

The postoperative analgesic effect of ibuprofen was compared with a co mbination of ibuprofen and codeine versus placebo. The study was prosp ective, randomized, double blind with 123 consecutive hip arthroplasty operations. All the patients received oral diazepam as premedication and spinal anaesthesia with bupivacaine 5 mg/ml 3-4 ml. Postoperativel y, when the spinal anaesthesia started to wear off, the patients were randomly assigned to one of three groups; the ibuprofen group (n=48) r eceived 800 mg of ibuprofen orally. The ibuprofen/codeine group (IC, n =48) received 800 mg of ibuprofen combined with 60 mg of codeine. The placebo group (P, n=25), received oral placebo medication. The patient s were observed for the need of additional opioid (e.g. ketobemidone), pain score (verbal and VAS), bleeding and side effects for five hours . The patients in the placebo group CP) had significantly higher pain scores (P<0.05) compared with the two other groups after 2 and 4 hours , with no significant differences after 1, 3 and 5 hours. The P group also received 45% more opioids (P<0.001) compared with the two other g roups during the same period. No significant differences in bleeding o r side-effects were observed between the groups. There were no signifi cant differences between the ibuprofen group and the ibuprofen/codeine group. We conclude that a prophylactic dose of 800 mg ibuprofen orall y has an opioid sparing effect with a tendency of less pain experience during the first hours after hip arthroplasty.