Comparison Between Ibuprofen and Paracetamol as Preemptive Analgesia during Laparotomy in General Anesthesia

Abstract

Introduction: Preemptive analgesia has the potential to be more effective than the same analgesic therapy given after surgery because of its protective effect on the nociceptive system. The purpose of this study was to analyze the comparison of ibuprofen and paracetamol as preemptive analgesia in patients undergoing laparotomy under general anesthesia at the Integrated Surgery Center (GBPT), Dr. Soetomo Hospital Surabaya.

Objectives: This study aims to compare the effectiveness of ibuprofen and paracetamol as preemptive analgesia in patients undergoing laparotomy surgery at Dr. Soetomo Hospital Surabaya. The research seeks to evaluate and compare the postoperative pain scores at 2 hours, 6 hours, and 24 hours between patients administered ibuprofen and those given paracetamol as preemptive analgesia. Additionally, the study aims to assess the need for additional opioids during and after surgery in patients receiving ibuprofen versus paracetamol as preemptive analgesia. Furthermore, the research will examine any potential differences in blood pressure, breathing frequency, heart rate frequency, and qNOX between patients administered ibuprofen and those given paracetamol as preemptive analgesia during the laparotomy surgery.

Methods: Analytical study, quasy experimental, prospective. A total of 30 patients with PS ASA 1-3 aged 18-60 years who underwent laparotomy were recruited in this study. In this study, strict monitoring was carried out using the qNOX device to maintain the depth of the anesthetic stage so that the anesthetic drug given was not excessive. Monitoring of blood pressure, respiratory rate, pulse, qNOX in patients given ibuprofen compared to paracetamol as preemptive analgesia during and post operatively. In addition, it was seen the addition of fentanyl during and post operatively.

Results: There were no significant differences in blood pressure, respiratory rate, pulse, qNOX in patients given ibuprofen compared to paracetamol as preemptive analgesia, there were no significant differences in the need for opioids during and postoperatively in patients given ibuprofen compared to paracetamol as preemptive analgesia. In the inter-variable test, a significant relationship was found between the addition of fentanyl and systolic blood pressure in paracetamol group (r=0,56 p value = 0.027, p value <0.05).

Conclusions: There were no significant differences in blood pressure, both systolic and diastolic, respiratory rate, pulse, qNOX in patients given ibuprofen compared to paracetamol as preemptive analgesia, there were no significant differences in the need for opioids during and postoperatively in patients given ibuprofen compared to paracetamol as preemptive analgesia.