Preemptive Oral Ibuprofen Improves Postoperative Analgesia Following Contraceptive Implant Removal: A Double-blinded, randomized trial
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Abstract
Background: The Ministry of Public Health has a policy to promote the use of contraceptive implants to prevent pregnancy in adolescents and women over 20 years old who have recently undergone pregnancy termination. Using preemptive analgesia to reduce pain from contraceptive implant removal may help enhance the service experience and encourage more individuals to choose this method of contraception.
Objective: To assess the efficacy of preoperative ibuprofen administration in reducing pain related to contraceptive implant removal surgery.
Methods: This was a double-blinded, randomized trial involving 76 female patients aged 18-30 years who underwent contraceptive implant removal at Buri Ram Hospital. Participants were randomly allocated (1:1) to the study group received ibuprofen preoperatively and placebo postoperatively, while the control group received placebo preoperatively and ibuprofen postoperatively. Pain scores were recorded during local anesthetic injection, immediately after the procedure, and at 1, 8 and 24 hours postoperatively. Additionally, the number of paracetamol tablets consumed by the patients within 24 hours postoperatively was recorded.
Results: Participants' baseline characteristics like age, weight, height, BMI, and operative time were similar between groups. Primary Outcome: This study compared the postoperative pain scores between both groups using generalized estimating equations (GEE) statistics. The analysis revealed that the average overall pain score of the treatment group was significantly lower than that of the control group, with a mean difference of 0.6 (p-value = 0.014) after controlling for other factors. Secondary Outcomes: The number of paracetamol tablets used in the treatment group was lower than in the control group (0.6 tablets vs. 1.6 tablets, p-value = 0.001). Adverse Outcomes: There was no evidence of adverse outcomes in either group.
Conclusions: The use of preemptive oral ibuprofen decreased pain scores and postoperative paracetamol consumption in patients undergoing contraceptive implant removal.
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