The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Ibuprofen an Option for Early Pain Control after Hip Replacement

Ibuprofen an Option for Early Pain Control after Hip Replacement

February 13, 2019 • By Reuters Staff

  • Tweet
  • Email
Print-Friendly Version / Save PDF

NEW YORK (Reuters Health)—Combining paracetamol (acetaminophen) with ibuprofen does not cut postoperative use of morphine in a clinically meaningful way relative to ibuprofen alone, in patients undergoing total hip arthroplasty (THA), results of a Danish randomized trial suggest.

You Might Also Like
  • Hip-Resurfacing Arthroplasty an Alternative to Total Hip Replacement
  • Ibuprofen More Likely to Raise BP than Naproxen or Celecoxib
  • Sarilumab Is Effective for RA, Pregabalin Fails to Meet Study Endpoint & Ibuprofen Can Be Administered with a Patch

“Although the combined use of paracetamol and ibuprofen reduced immediate postoperative morphine consumption compared with paracetamol alone in patients undergoing THA, ibuprofen alone resulted in comparable pain control without increasing serious adverse events,” the researchers report in JAMA, online Feb. 12.1

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Dr. Kasper Højgaard Thybo from Naestved Hospital and colleagues evaluated the beneficial and harmful effects of four oral nonopioid analgesic regimens taken every six hours for 24 hours following THA and starting one hour before surgery.

By random allocation, 136 patients received 1,000 mg of paracetamol (acetaminophen) plus 400 mg of ibuprofen, 142 received 1,000 mg of paracetamol plus placebo, 141 received 400 mg of ibuprofen plus placebo and 140 received half-strength 500 mg of paracetamol plus 200 mg of ibuprofen.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The two co-primary outcomes were 24-hour morphine consumption using patient-controlled analgesia and the proportion of patients with one or more serious adverse events within 90 days.

Median 24-hour morphine consumption was 20 mg in the paracetamol/ibuprofen group, 36 mg for paracetamol alone, 26 mg for ibuprofen alone and 28 mg for half-strength paracetamol/ibuprofen.

Morphine consumption in the first 24 hours was statistically significantly lower for the combination of 1,000 mg of paracetamol plus 400 mg of ibuprofen than for either agent alone, the investigators report, findings that “support the principle of multi-modal analgesia with paracetamol plus ibuprofen compared with paracetamol alone for the first postoperative day.”

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

However, compared with ibuprofen alone, the morphine-sparing effect of the combination was below the prespecified threshold for a clinically important postoperative morphine reduction (10 mg), “suggesting that ibuprofen alone may be a reasonable option for early postoperative oral analgesia,” they say.

There was no statistically significant difference in the percentage of patients with serious adverse events in any of the ibuprofen groups vs. paracetamol alone (15% vs. 11%).

The authors say a limitation of the trial is that the intervention period was only 24 hours, “and a prolonged intervention period could have been more appropriate as treatment with paracetamol plus ibuprofen seldom is used for only 24 hours in a clinical context.”

The study had no commercial funding and the authors made no relevant disclosures.

Dr. Thybo did not respond to a request for comment by press time.


Reference

  1. Thybo KH, Hägi-Pedersen D, Dahl JB, et al. Effect of combination of paracetamol (acetaminophen) and ibuprofen vs. either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty: The PANSAID randomized clinical trial. JAMA. 2019 Feb 12;321(6):562–571. doi: 10.1001/jama.2018.22039.

Pages: 1 2 | Multi-Page

Filed Under: Analgesics, Drug Updates Tagged With: hip, hip arthroplasty, Ibuprofen, Pain, Pain Management, surgery, total hip arthroplasty, total hip replacement

You Might Also Like:
  • Hip-Resurfacing Arthroplasty an Alternative to Total Hip Replacement
  • Ibuprofen More Likely to Raise BP than Naproxen or Celecoxib
  • Sarilumab Is Effective for RA, Pregabalin Fails to Meet Study Endpoint & Ibuprofen Can Be Administered with a Patch
  • Patients with PsA, Cutaneous Psoriasis May Undergo Hip Replacement

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.