Ibuprofen and other NSAIDs greater than codeine for the management of postoperative pain in an outpatient setting

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen offer better pain control and have fewer side effects than codeine, a commonly prescribed opioid, when prescribed after outpatient surgery, according to a news report. research published in CMAJ (Journal of the Canadian Medical Association).

“In all types of surgery, subgroups and outcome time points, NSAIDs were equal to or greater than codeine for postoperative painWrites Dr. Matthew Choi, associate professor of surgery at McMaster University, with the co-authors.

Researchers conducted a systematic review and meta-analysis of 40 high-quality randomized controlled trials (RCTs) involving more than 5,100 adults to compare pain the levels and safety of drugs containing codeine, such as Tylenol # 3, with NSAIDs. Patients taking NSAIDs had lower pain scores at 6 and 12 hours after treatment than patients taking codeine.

“We found that patients randomized to receive NSAIDs after outpatient surgeries reported better pain scores, better overall assessment scores, fewer side effects, and no difference in bleeding events, compared to those receiving codeine, “write the authors.

Codeine is widely used for the management of postoperative pain and is the most commonly prescribed opioid in Canada. However, codeine is associated with a range of adverse effects and potential abuse or dependence. Alternatives such as NSAIDs can help reduce opioid use in patients after dental and surgical procedures.

Given the range of procedures and dosage combinations included in high-quality RCTs, the authors suggest that their results have wide clinical application.

“These findings are of general importance to any clinician performing painful medical procedures. The various trials in our meta-analysis evaluated a range of procedures, different types of NSAIDs, and varying degrees of acetaminophen administration.”

The authors conclude that their findings “reinforce the existing evidence and are broadly generalizable to patients from all surgical disciplines.”

“Management of postoperative pain in ambulatory adults: a Systematic review and a meta-analysis comparing codeine to NSAIDs “is published on June 14, 2021.