A Prospective Randomized Comparative Study: Efficacy of Intravenous Ibuprofen Infusion Used as Pre-Emptive Analgesia in Patients Undergoing Elective Laparoscopic Cholecystectomy
Abstract
Background: Post-operative pain following laparoscopic cholecystectomy remains a common clinical concern, often necessitating opioid use that may result in undesirable side effects. Pre-emptive administration of non-steroidal anti-inflammatory drugs (NSAIDs) has been proposed as an effective opioid-sparing strategy. Aim and Objective: To evaluate the efficacy of intravenous (IV) ibuprofen compared with placebo when used as pre-emptive analgesia in patients undergoing elective laparoscopic cholecystectomy under general anaesthesia. Materials and Methods: This prospective, randomized, double-blinded, placebo-controlled study was conducted at SVBP Hospital, LLRM Medical College, Meerut, from May 2023 to April 2025. Sixty ASA I-II patients aged 20-60 years scheduled for elective laparoscopic cholecystectomy were enrolled and randomly allocated into two groups (n = 30 each). Group B received IV ibuprofen 400 mg in 100 ml saline, while Group C received 100 ml saline (placebo), both administered 30 minutes before induction. Standardized anaesthetic protocols were followed. Post-operative pain was assessed using the Visual Analogue Scale (VAS) at intervals up to 12 hours. Rescue analgesia with IV Tramadol (2 mg/kg) was administered if VAS >3, and total opioid consumption was recorded. Hemodynamic parameters and adverse events were also documented. Results: VAS scores were significantly lower in the ibuprofen group compared to placebo at 15 min, 30 min, 1 hr, 4 hr, 10 hr, and 12 hr postoperatively (p < 0.05). No significant differences were observed at 2 hr, 6 hr, and 8 hr. Mean Tramadol consumption was significantly reduced in the ibuprofen group (223 ± 43 mg) versus placebo (290 ± 30.5 mg; p = 0.0037). Hemodynamic parameters (pulse rate, SBP, DBP, MAP, SpO2) remained stable in both groups, and adverse effects were minimal and comparable. Conclusion: Pre-emptive IV ibuprofen significantly reduces post-operative pain scores and opioid requirements compared to placebo, without compromising hemodynamic stability or safety. It represents a safe and effective component of multimodal analgesia for laparoscopic cholecystectomy.Keywords:
Ibuprofen, Pre-Emptive Analgesia, Laparoscopic Cholecystectomy, Opioid-Sparing, Post-Operative PainReferences
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