Ibuprofen timing for hand surgery in ambulatory care

Abstract

Objective: To evaluate the effect of pre-operative administration of ibuprofen on post-operative pain control vs. early post-operative administration for hand surgery procedures performed under local anaesthesia in ambulatory care.

Methods: Candidates to trigger finger release by De Quervain tenosynovitis and carpal tunnel operation under local anesthesia were enrolled in the study. Group A received 400 mg ibuprofen before the operation and placebo after the procedure; group B received placebo before the operation and ibuprofen 400 mg at the end of the procedure; both groups received ibuprofen 400 mg every 6h thereafter. Visual analogue scale (VAS) was measured at fixed times before and every 6h after surgery, for a total follow-up of 18h.

Results: Groups were similar according to age, gender and type of surgery. Median VAS values did not produce any statistical significance, while there was a statistically significant difference on pre-operative and early post-operative VAS values between groups (A -8.53 mm vs. B 3.36 mm, p=0.0085).

Conclusion: Average pain levels were well controlled by local anesthesia and post-operative ibuprofen analgesia. Pre-operative ibuprofen administration can contribute to improve early pain management. Level of Evidence II, Therapeutic Studies.

Keywords: Analgesics/therapeutic use; Carpal tunnel syndrome; De Quervain Disease; Ibuprofen; Trigger finger disorder.

Figure 1.. Enrolment flowchart.

Figure 2.. Median VAS values (mm) at baseline (T0), after the procedure (T1), at 6 hours (T2), at 12 hours (T3), at 18 hours (T4) after the operation

Figure 3.. Median VAS values (mm) differences between T0 and T1, T1 and T2, T2 and T3, T3 and T4. T0, baseline; T1 after the procedure; T2, at 6 hours; T3, at 12 hours; T4, at 18 hours after the operation.