Prospective Randomized ControlledResearch Comparing IntravenousIBUPROFEN and Intravenous KETOROLACfor Acute Post-operative Pain in PatientsUndergoing Abdominal Surgery

Abstract

Introduction: Recovery is greatly impacted by acute post-operative pain, which also affects patient outcomes and
comfort. Non-steroidal anti-inflammatory drugs (NSAIDs), which lower opioid usage and improve pain management,
are essential parts of multimodal pain therapy. By obstructing enzymes cyclooxygenase (COX)-1 and COX-2, NSAIDs
like ibuprofen and ketorolac provide analgesia by blocking the synthesis of pain-related prostaglandins. Both drugs are
commonly used intravenously, but limited studies have compared their efficacy in surgical settings. This prospective
randomized study aims to evaluate the efficacy, safety, and tolerability of intravenous (IV) ibuprofen versus IV ketorolac
in managing acute post-operative pain in abdominal surgery patients. Methods: The prospective randomized controlled
trial took place at a tertiary hospital using 60 patients who were to undergo abdominal surgery, divided equally into
two Groups A and B, receiving IV ketorolac and ibuprofen respectively, administered 6-hourly. Variables measured
included heart rate, mean arterial blood pressure, visual analogue scale (VAS) score, opioid usage in the first 24 h post-
surgery, time to ambulate, and time to request first analgesic. Results: The Ibuprofen group presented lesser 24 h opioid
requirement compared with Ketorolac group, with a mean of 44.0 ± 23.31 mg and 108.0 ± 14.68 mg, respectively,
with P < 0.01. Relatively lower VAS scores, inclusive of patients in both rest as well as movement was observed in
group B. The overall VAS scores at rest in Group A and B, respectively, are 4.23 ± 1.23 and 3.37 ± 1.18 with P = 0.007,
whereas the overall VAS scores during movement are 4.66 ± 1.25 and 3.61 ± 1.13 with P = 0.01. The time to ambulate
is significantly lower in Group B, and only 20% patients woke up during the night due to pain. Group B took a longer
time to request the first analgesic dose (344.0 ± 89.53 min) compared with group A (162.40 ± 59.13), with P < 0.01.
The patients in Group B also showed more hemodynamic stability than patients in Group A. Conclusion: As found
from the results gathered from this research study, the use of IV ibuprofen is more effective than IV ketorolac in terms
of providing analgesia following abdominal surgery because pain reduction is more significant, along with lower doses
of opioid medications for 24 h post-surgery.