Intravenous ibuprofen: A key addition to perioperative pain management

Feb 23 2012

Hendersonville Medical Center today announced that anesthesiologist Peter B. Kroll, M.D., has published an article in the January issue of peer-reviewed medical journal Pain Management. The article, titled "Intravenous Ibuprofen for Postoperative Pain," reviews the growing body of research demonstrating the safety and efficacy of Caldolor® (ibuprofen) Injection for the management of surgical pain and purports potential expanded uses and cost benefits of the drug.

In 2009, Caldolor became the first injectable product approved by the FDA with a dual indication for treatment of pain and fever in adults. Due to its broad indication, Caldolor is being used by physicians in a wide variety of settings to treat pain and fever in hospitalized patients. This includes an increasing number of anesthesiologists who are using Caldolor at induction of anesthesia to preemptively address pain and inflammation associated with surgical procedures.

"Intravenous ibuprofen is a key addition to the perioperative pain management regimen in any surgical setting," said Dr. Kroll, Director of Comprehensive Pain Specialists and a practicing physician at Hendersonville Medical Center. "It's important for medical professionals to be aware of this new research and how it may help them improve care for their patients, now and in the future."

The article provides a comprehensive overview of Caldolor, including its pharmacology, usage, adverse reactions and drug interactions, as well as the results of three adult surgical clinical trials, which indicated patients receiving the drug versus placebo experienced less pain, had a reduced need for opioid analgesics and recovered from surgery more quickly. Dr. Kroll served as the lead investigator in one of the trials, which confirmed that 800 mg of intravenous ibuprofen given every six hours was safe and effective for the treatment of postoperative pain following abdominal hysterectomy.

The World Health Organization has recommended a multi-modal approach to pain management, with non-opioid analgesics such as ibuprofen recommended as first-line treatment. Caldolor offers IV delivery of ibuprofen to control pain and has significantly reduced opioid consumption by up to 31% immediately following surgery. Reduction in opioid use could reduce opioid-related side effects such as sedation, nausea, vomiting, cognitive impairment and respiratory depression.

Looking ahead, the article also suggests the use of Caldolor in combination with regional anesthesia, such as nerve blocks, could further reduce opioid use or eliminate it completely. Dr. Kroll also explores possible future uses and impacts of intravenous ibuprofen, proposing that it could play a role in non-surgical pain management in multiple settings, including the emergency department for musculoskeletal injuries and migraine headache, the hospital floor for general pain management, and outpatient surgery centers to speed discharge and limit narcotic use. In addition, the article theorizes that future studies may examine the role the drug could play in reducing healthcare costs by speeding patient recovery and shortening hospital stays.

"We're still in the early stages of using this drug," Dr. Kroll said. "I expect that, in the years to come, researchers will discover its analgesic utility beyond post-operative pain."