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Comparing Ketorolac With Ibuprofen for Postoperative Pain: A Randomized Clinical Trial.
Dwarica, DS, Pickett, SD, Zhao, YD, Nihira, MA, Quiroz, LH
Female pelvic medicine & reconstructive surgery. 2020;(4):233-238
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Abstract
OBJECTIVES The objective of this study was to identify differences in pain perception and satisfaction with pain control in women receiving nonsteroidal anti-inflammatory drugs postoperatively. METHODS This was a prospective, randomized controlled trial including urogynecology surgical patients. After surgery, all patients were randomized to receive either intravenous (IV) ketorolac or ibuprofen. The patients completed 3 visual analog scales (VAS) assessing pain at rest, pain with ambulation, and satisfaction with pain control. Postoperative opioid use was also measured. RESULTS A total of 224 patients (112 in each arm) were included. Pain scores (SD) at rest in all patients who received ketorolac versus those who received ibuprofen was 2.30 (2.1) versus 2.68 (2.34) (P = 0.20). Pain scores (SD) with ambulation was 3.94 (2.57) versus 4.16 (2.73) (P = 0.57) in patients who received ketorolac and ibuprofen, respectively. Patients who received ketorolac rated their satisfaction with their pain regimen similarly to those who received ibuprofen (P = 0.50). The average amount (SD) of hydromorphone used in the ketorolac and ibuprofen arm was 3.68 (4.58) mg and 4.04 (4.97) mg, respectively (P = 0.58). A subgroup analysis based on type of surgery showed decreased pain at rest (VAS, 2.77 vs 4.88; P = 0.04) and increased satisfaction (VAS, 1.69 vs 4.67; P = 0.003) in patients who had laparotomy and received ketorolac. CONCLUSIONS There was no difference in pain and satisfaction with IV ketorolac compared with IV ibuprofen in patients who underwent all modalities of urogynecologic surgery. A subgroup of patients who underwent laparotomy had less pain with ketorolac.
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Effect of Ibuprofen on Muscle, Hematological and Renal Function, Hydric Balance, Pain, and Performance During Intense Long-Distance Running.
de Souza, RF, de Matos, DG, Ferreira, ARP, Chilibeck, P, Barros, NA, Oliveira, AS, Cercato, LM, da Silva, DS, Aidar, FJ
Journal of strength and conditioning research. 2020;(7):2076-2083
Abstract
de Souza, RF, de Matos, DG, Ferreira, ARP, Chilibeck, P, Barros, NdA, de Oliveira, AS, Cercato, LM, da Silva, DS, and Aidar, FJ. Effect of ibuprofen on muscle, hematological and renal function, hydric balance, pain, and performance during intense long-distance running. J Strength Cond Res 34(7): 2076-2083, 2020-The aim of this study was to investigate the effect of prophylactic use of nonsteroidal anti-inflammatory drugs (i.e., ibuprofen) on physical performance, vertical jump, muscle biomarkers, liver, kidney, acute pain, and hydration status of participants in the 42-km Trail Running Challenge, a long-distance race integrated over mountain routes. The sample consisted of 20 men randomly divided into 2 groups: a control group (CG) and an experimental group (EG), with 12 completing the race (41.1 ± 8.8 years; 75.7 ± 12.1 kg) and included in the final analysis. The EG were administered an ibuprofen capsule (400 mg) 15 minutes before the beginning of the race and again after 5 hours of racing if the route was not yet completed. There were significant time main effects for creatine kinase (p = 0.001; f Cohen = 0.25), lactate dehydrogenase (p < 0.001; f Cohen = 2.05), aspartate aminotransferase (p = 0.002; f Cohen = 1.53), creatinine (p = 0.002; f Cohen = 2.24), urea (p = 0.001; f Cohen = 2.25), heart rate (p < 0.001; f Cohen = 4.88), and pain scores (p < 0.001; f Cohen = 1.93) all of which increased during the race. There was a group × time interaction for squat jump, which significantly decreased only in the CG (p = 0.045; f Cohen = 2.17). This may have been related to increased frequency of pain reported after the race in the gastrocnemius of the CG compared with the EG (p ≤ 0.05). It was concluded that ibuprofen intake did not reduce muscle damage during the competition but maintained leg muscular power performance (i.e., vertical jump), possibly by reducing gastrocnemius muscle pain.
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Ibuprofen as a corrosion inhibitor for copper in synthetic acid rain solution.
Tasić, ZZ, Mihajlović, MBP, Simonović, AT, Radovanović, MB, Antonijević, MM
Scientific reports. 2019;(1):14710
Abstract
It is known that if unused drugs are improperly disposed, they can pollute the environment. Furthermore, researchers are still trying to find an environmentally friendly corrosion inhibitor. These factors lead to the possible application of unused pharmaceutical compounds as corrosion inhibitors. The feasibility of an anti-inflammatory, analgesic and antipyretic drug, ibuprofen, was evaluated as a potential copper corrosion inhibitor in synthetic acid rain solution. This investigation was performed by applying electrochemical and weight loss measurements and quantum chemical calculations. The results obtained by these techniques revealed the ability of ibuprofen to protect copper from corrosion. The inhibition efficiency of ibuprofen rises with increase in its concentration and can reach a value of 97.3%. The results of surface analysis of treated coupons by scanning electron microscopy and theoretical calculations are consistent with the experimental results.
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Effect of ibuprofen on semen quality.
Banihani, SA
Andrologia. 2019;(4):e13228
Abstract
Ibuprofen is a widely used analgesic/antipyretic medication belongs to the nonsteroidal anti-inflammatory class. Even though the influence of ibuprofen on semen quality has been investigated in various occasions, the comprehensive understanding and discussion of its impact on semen quality is still yet to be determined. In this work, we systematically review and reveal the effect of ibuprofen on semen quality, and thus on fertilising capability. To achieve this goal, we searched the main research databases (Scopus and PubMed) from 1 June 1986 through 13 October 2018 for English-language articles and abstracts using the keywords "ibuprofen" versus "semen" and "sperm". In addition, related published articles or abstracts were also discussed if relevant. Altogether, the main stream of research, from both in vitro and in vivo studies, presents an adverse effect of ibuprofen on different sperm parameters such as motility, viability, count and DNA integrity; however, such effect is not yet confirmed in humans. Mechanisms by which ibuprofen affects semen quality may be by reducing testosterone and prostaglandin synthesis, chelating zinc ions and inhibiting nitric oxide synthesis. However, further research studies, mainly clinical, are still of great importance to confirm the effects of ibuprofen on semen quality.
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PDA-TOLERATE Trial: An Exploratory Randomized Controlled Trial of Treatment of Moderate-to-Large Patent Ductus Arteriosus at 1 Week of Age.
Clyman, RI, Liebowitz, M, Kaempf, J, Erdeve, O, Bulbul, A, Håkansson, S, Lindqvist, J, Farooqi, A, Katheria, A, Sauberan, J, et al
The Journal of pediatrics. 2019;:41-48.e6
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Abstract
OBJECTIVE To compare early routine pharmacologic treatment of moderate-to-large patent ductus arteriosus (PDA) at the end of week 1 with a conservative approach that requires prespecified respiratory and hemodynamic criteria before treatment can be given. STUDY DESIGN A total of 202 neonates of <28 weeks of gestation age (mean, 25.8 ± 1.1 weeks) with moderate-to-large PDA shunts were enrolled between age 6 and 14 days (mean, 8.1 ± 2.2 days) into an exploratory randomized controlled trial. RESULTS At enrollment, 49% of the patients were intubated and 48% required nasal ventilation or continuous positive airway pressure. There were no differences between the groups in either our primary outcome of ligation or presence of a PDA at discharge (early routine treatment [ERT], 32%; conservative treatment [CT], 39%) or any of our prespecified secondary outcomes of necrotizing enterocolitis (ERT, 16%; CT, 19%), bronchopulmonary dysplasia (BPD) (ERT, 49%; CT, 53%), BPD/death (ERT, 58%; CT, 57%), death (ERT,19%; CT, 10%), and weekly need for respiratory support. Fewer infants in the ERT group met the rescue criteria (ERT, 31%; CT, 62%). In secondary exploratory analyses, infants receiving ERT had significantly less need for inotropic support (ERT, 13%; CT, 25%). However, among infants who were ≥26 weeks gestational age, those receiving ERT took significantly longer to achieve enteral feeding of 120 mL/kg/day (median: ERT, 14 days [range, 4.5-19 days]; CT, 6 days [range, 3-14 days]), and had significantly higher incidences of late-onset non-coagulase-negative Staphylococcus bacteremia (ERT, 24%; CT,6%) and death (ERT, 16%; CT, 2%). CONCLUSIONS In preterm infants age <28 weeks with moderate-to-large PDAs who were receiving respiratory support after the first week, ERT did not reduce PDA ligations or the presence of a PDA at discharge and did not improve any of the prespecified secondary outcomes, but delayed full feeding and was associated with higher rates of late-onset sepsis and death in infants born at ≥26 weeks of gestation. TRIAL REGISTRATION ClinicalTrials.gov: NCT01958320.
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Pain Management After Surgical Tonsillectomy: Is There a Favorable Analgesic?
Jotić, A, Savić Vujović, K, Milovanović, J, Vujović, A, Radin, Z, Milić, N, Vučković, S, Medić, B, Prostran, M
Ear, nose, & throat journal. 2019;(6):356-361
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Abstract
The aim of this study was to examine how ibuprofen and paracetamol prevent pain after cold-steel extracapsular tonsillectomy in children. Also, we examined the relation between age, gender, nausea, postoperative bleeding, antibiotic use, type of diet, and postoperative pain intensity and the type of administered analgesic. A prospective study was conducted on 147 children (95 males and 52 females, aged 7-17 years) who underwent tonsillectomy in the Clinical-Hospital Center "Dragiša Mišović" from January 1 to June 30, 2016. The degree of pain was measured using a visual analog scale (VAS). We did not observe any significant differences in postoperative nausea, hospitalization rate postoperative bleeding, and antibiotic use between the paracetamol and ibuprofen groups. A test of within-patient effects showed that VAS scores changed significantly during the postoperative follow-up period (P = .00), but there were no significant differences between the groups (P = .778). After 12 hours, 29.3% of the patients on paracetamol and 21.8% on ibuprofen were transferred to a soft diet; after 24 hours, 84.8% of the paracetamol group and 85.5% of the ibuprofen group were on a soft diet (χ2 test, P < .05). There was a statistically significant correlation between VAS scores measured 4 hours after the surgery and the time of transference to the soft diet (Spearman ρ test, P < .001). The transfer to soft and normal diets was not significantly different between the 2 groups as assessed by the VAS scores (Pearson χ2 test, P = .565).There is still no consensus on the most effective postoperative pain-control regiment after tonsillectomy. This study showed that satisfactory pain management was achieved equally with both paracetamol and ibuprofen.
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Longer analgesic effect with naproxen sodium than ibuprofen in post-surgical dental pain: a randomized, double-blind, placebo-controlled, single-dose trial.
Cooper, SA, Desjardins, P, Brain, P, Paredes-Diaz, A, Troullos, E, Centofanti, R, An, B
Current medical research and opinion. 2019;(12):2149-2158
Abstract
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line medications in mild-to-moderate acute pain. However, comparative data regarding the duration of analgesia for commonly-used NSAIDs at non-prescription doses is lacking. This study evaluated the time to rescue medication following a single dose of naproxen sodium (NAPSO) vs ibuprofen (IBU) and placebo in subjects with moderate-to-severe post-surgical dental pain.Methods: This single-center, randomized, double-blind, parallel group, placebo-controlled study included healthy subjects with moderate-to-severe baseline pain (Categorical Pain Intensity Scale) who also rated their pain ≥ 5 on a 0-10 pain intensity Numerical Rating Scale following extraction of two impacted mandibular third molars. A single oral dose of NAPSO (440 mg), IBU (400 mg), or placebo was administered. The primary efficacy endpoint was the time to first rescue medication, while secondary endpoints included the sum of pain intensity difference (SPID) and total pain relief (TOTPAR) over 24 h. ClinicalTrials.gov trial registration number: NCT03404206 (EudraCT 2017-005049-67).Results: In the per protocol population (n = 385; mean age = 19 years), the time to rescue medication was significantly (p < .001) longer with NAPSO than IBU and placebo. After treatment, the greatest separation of NAPSO from IBU occurred at 9-14 h and from placebo at 1-6 h. Fewer NAPSO subjects required rescue medication (58/166, 34.9%) compared with IBU (137/165, 83.0%) and placebo (44/54, 81.5%). SPID 0-24 h and TOTPAR 0-24 h were both greater with NAPSO than IBU or placebo.Conclusions: The duration of pain relief after a single dose of NAPSO was significantly longer than after IBU, and significantly fewer NAPSO-treated subjects required rescue medication over a 24-h period.