• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Public Health

Paracetamol plus ibuprofen significantly reduces post-operative morphine use in total hip arthroplasty patients

byBrittany Hasty, MDandDaniel Fisher
February 12, 2019
in Public Health, Surgery
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. In this randomized controlled trial, ibuprofen plus paracetamol significantly reduced morphine consumption in post-operative patients who underwent a total hip arthroplasty compared with paracetamol alone

2. There was no significant difference in serious adverse events in groups receiving ibuprofen and those receiving paracetamol.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Multimodal postoperative analgesia is widely used as a way to reduce the amount of opiates consumed, and thus, many multimodal postoperative analgesia protocols include nonopioid medications such as paracetamol, also known as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs). However, the optimal analgesia strategy is still unclear. In this randomized controlled trial, the combination of paracetamol and ibuprofen significantly reduced morphine consumption for 24 hours post-operatively in total hip arthroplasty (THA) patients compared to those who only received paracetamol. There was no significant difference in the morphine-sparing effect between the combination of paracetamol and ibuprofen compared to ibuprofen alone. There were no differences in severe adverse effects between groups. Patient-reported pain scores at 24 hours were also significantly lower with paracetamol plus ibuprofen compared with either ibuprofen alone or paracetamol alone.

Though this study suggests combination ibuprofen and paracetamol may be superior to either drug along, patients who pre-operatively were being treated with gabapentinoids, glucocorticoids, selective serotonin reuptake inhibitors, tramadol, or codeine were not excluded from this study, and these medications were continued in the peri-operative period, representing a possible source of confounding. In addition, over 30% of patients were taking daily NSAIDs prior to surgery.

Click to read the study, published today in JAMA

Relevant Reading: Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review

RELATED REPORTS

Substance use and mental health conditions in adolescents associated with future non- prescription opioid use

Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students

Quick Take: Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial

In-Depth [randomized controlled trial]: In the Paracetamol and NSAID (PANSAID) trial, a total of 556 patients were included in the primary analysis to determine the morphine-sparing effect of the addition of non-opiates in post-operative pain control. Patients were recruited from December 2015 to October 2017 in six Danish hospitals and were randomized to receive a combination of paracetamol (1000 mg) and ibuprofen (400mg; n= 136), paracetamol alone (n= 142), ibuprofen alone (n= 139), or a half dose paracetamol (500 mg) and ibuprofen (200 mg; n= 139). Overall the median 24-hour morphine consumption was 20 mg in the full dose combination group, 36 mg in the paracetamol alone group, 26 mg in the ibuprofen alone group, and finally 28 mg in the half dose combination group. Patients in the full dose combination group consumed significantly less morphine in the post-operative period when compared to paracetamol alone (CI99.6 6.5 to 24mg). There was no significant difference in morphine consumption between the ibuprofen-alone group and the half dose combination group (difference 2 mg; CI99.6 -10 to 7). At 24 hours, patients in the full dose combination group reported significantly lower pain scores at rest than all other groups (p < 0.05). Overall 14% of patients reported 1 or more severe adverse event. The relative risk of a serious adverse event was 1.44 (CI97.5 0.79 to 2.64).

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: ibuprofenmorphineopiodsparacetamolpost-operative pain
Previous Post

The PIONEER-HF Trial: Sacubitril-valsartan linked to superior outcomes in acute decompensated heart failure

Next Post

USPSTF: Counseling interventions likely to prevent perinatal depression

RelatedReports

Quick Take: The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomized trial
Chronic Disease

Substance use and mental health conditions in adolescents associated with future non- prescription opioid use

August 19, 2021
Quick Take: The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomized trial
Pediatrics

Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students

March 17, 2021
Quick Take: Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial
Pediatrics

Quick Take: Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial

December 10, 2018
National acute HCV infections may be underestimated
Chronic Disease

Designer opioid receptor agonist provides pain relief without opioid side effects in nonhuman primates [PreClinical]

September 8, 2018
Next Post
Earlier puberty associated with increased risk of depression in girls

USPSTF: Counseling interventions likely to prevent perinatal depression

Addressing non-obesity related barriers may improve bariatric surgery effectiveness

Symptomatic and non-symptomatic heart failure associated with increased postoperative mortality in non-cardiac elective surgery

Quick Take: Assessment of application-driven postoperative care in the pediatric tonsillectomy population: a survey-based pilot study

Quick Take: Assessment of application-driven postoperative care in the pediatric tonsillectomy population: a survey-based pilot study

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Bimekizumab shows a favourable 2-year safety profile in patients with moderate to severe plaque psoriasis
  • Medical cannabis provides little improvement to sleep in chronic pain patients
  • Alzheimer disease in individuals with Down syndrome has similar variability in age of onset and mortality rate as autosomal dominant forms
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.