Acil Serviste Akut Mekanik Bel Ağrılarında Ibuprofen 400 mg and 800 mg Intravenöz formlarının analjezik etkilerinin karşılaştırılması: Prospektif, Randomize Klinik ve Çift Kör Çalışma

Yıl 2024, Cilt: 7 Sayı: 2, 309 - 316, 05.07.2024

Safa Dönmez Erdal Tekin Ahmet Burak Erdem Alp Şener Miray Tümer Mehmet Yılmaz Nurullah İshak Işık İbrahim Ozlu

Öz

Amaç: Bu çalışmanın amacı, akut mekanik bel ağrısı için intravenöz (IV) ibuprofenin 400 mg ve 800 mg dozlarının analjezik etkinliğini karşılaştırmaktı.
Yöntemler: Orospektif, randomize, çift-kör kontrollü klinik bir çalışma tasarımı kullanıldı. Orta ila şiddetli akut bel ağrısı olan hastalar çalışmaya dahil edildi. Etik onay alındı ve hastalar yazılı onay verdiler. Çalışma etik kurallara ve İyi Klinik Uygulama prensiplerine uygun olarak yürütüldü.
Bulgular: 144 hastadan, demografik özellikler gruplar arasında benzerdi. 800 mg IV ibuprofen grubu, 400 mg grubuna göre üstün analjezik etkinlik gösterdi ve önemli bir yan etki rapor edilmedi.
Sonuç: Çalışma, akut mekanik bel ağrısı olan hastalarda 800 mg IV ibuprofen dozunun, 30. dakika hariç tüm zaman aralıklarında analjezi kontrolü sağlamada daha etkili olduğunu sonuçlandırdı.

Anahtar Kelimeler

Akut bel ağrısı, ibuprofen, intravenöz, analjezik etkinlik

The Comparative Efficacy of Intravenous Ibuprofen 400 mg and 800 mg in Acute Mechanical Low Back Pain: A Prospective, Randomized, Double-Blind Clinical Study

Öz

Objective: This study aimed to compare the analgesic efficacy of intravenous (IV) ibuprofen at doses of 400 mg and 800 mg for acute mechanical low back pain.
Methods: A Prospective, randomized, double-blind controlled clinical trial design was employed. Patients with moderate to severe acute low back pain were recruited from emergency departments. Ethical approval was obtained, and patients provided written consent. The study adhered to ethical guidelines and Good Clinical Practice principles.
Results: Of the 144 patients, demographic characteristics were similar between groups. The 800 mg IV ibuprofen group demonstrated superior analgesic efficacy compared to the 400 mg group, with no significant adverse effects reported.
Conclusion: The study concludes that the 800 mg IV dose of ibuprofen was more effective in providing analgesia control for patients with acute mechanical low back pain at all time intervals except for the 30th minute.

Anahtar Kelimeler

Acute low back pain, ibuprofen, intravenous, analgesic efficacy

Kaynakça

• Codispoti, J. R., Prior, M. J., Fu, M., Harte, C. M., & Nelson, E. B. (2001). Efficacy of nonprescription doses of ibuprofen for treating migraine headache. a randomized controlled trial. Headache, 41(7), 665–679.
• Derry, C., Derry, S., Moore, R. A., & McQuay, H. J. (2009). Single dose oral ibuprofen for acute postoperative pain in adults. The Cochrane database of systematic reviews, 2009(3), CD001548.
• Dixit R.K. (2013). Chapter 10. approach to the patient with low back pain. Imboden J.B., & Hellmann D.B., & Stone J.H.(Eds.), CURRENT Diagnosis & Treatment: Rheumatology, 3e. McGraw Hill.
• Dogan, C., Yilmaz, A., Ozen, M., Seyit, M., Oskay, A., Kemanci, A., Uluturk, M., & Turkcuer, I. (2022). Comparative evaluation of the effectiveness of intravenous paracetamol, dexketoprofen and ibuprofen in acute low back pain. The American journal of emergency medicine, 56, 223–227.
• Firdous S, Mehta Z, Fernandez C, Behm B, Davis M, (2017) A comparison of Numeric Pain Rating Scale (NPRS) and the Visual Analog Scale (VAS) in patients with chronic cancer associated pain, Journal of Clinical Oncology, 35(31), 217.
• French L. (2005). Dysmenorrhea. American family physician, 71(2), 285–291.
• Friedman, B. W., Irizarry, E., Chertoff, A., Feliciano, C., Solorzano, C., Zias, E., & Gallagher, E. J. (2020). Ibuprofen Plus Acetaminophen Versus Ibuprofen Alone for Acute Low Back Pain: An Emergency Department-based Randomized Study. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine, 27(3), 229–235.
• Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The Epidemiology of low back pain. Best practice & research. Clinical rheumatology, 24(6), 769–781.
• Irizarry, E., Restivo, A., Salama, M., Davitt, M., Feliciano, C., Cortijo-Brown, A., & Friedman, B. W. (2021). A randomized controlled trial of ibuprofen versus ketorolac versus diclofenac for acute, nonradicular low back pain. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine, 28(11), 1228–1235.
• Lee, G. G., Park, J. S., Kim, H. S., Yoon, D. S., & Lim, J. H. (2022). Clinical effect of preoperative intravenous non-steroidal anti-inflammatory drugs on relief of postoperative pain in patients after laparoscopic cholecystectomy: Intravenous ibuprofen vs. intravenous ketorolac. Annals of hepato-biliary-pancreatic surgery, 26(3), 251–256.
• Ostojic, P., Radunovic, G., Lazovic, M., & Tomanovic-Vujadinovic, S. (2017). Ibuprofen plus paracetamol versus ibuprofen in acute low back pain: a randomized open label multicenter clinical study. Ibuprofen plus paracetamol versus ibuprofen in acute low back pain: a randomized open label multicenter clinical study. Acta reumatologica portuguesa, 42(1), 18–25.
• Pohjolainen, T., Jekunen, A., Autio, L., & Vuorela, H. (2000). Treatment of acute low back pain with the COX-2-selective anti-inflammatory drug nimesulide: results of a randomized, double-blind comparative trial versus ibuprofen. Spine, 25(12), 1579–1585.
• Skovron M. L. (1992). Epidemiology of low back pain. Bailliere's clinical rheumatology, 6(3), 559–573.
• Southworth, S., Peters, J., Rock, A., & Pavliv, L. (2009). A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen 400 and 800 mg every 6 hours in the management of postoperative pain. Clinical therapeutics, 31(9), 1922–1935.
• Sullivan, W. J., Panagos, A., Foye, P. M., Sable, A. W., Irwin, R. W., & Zuhosky, J. P. (2007). Industrial medicine and acute musculoskeletal rehabilitation. 2. Medications for the treatment of acute musculoskeletal pain. Archives of physical medicine and rehabilitation, 88(3 Suppl 1), S10–S13.
• Traeger, A. C., Lee, H., Hübscher, M., Skinner, I. W., Moseley, G. L., Nicholas, M. K., Henschke, N., Refshauge, K. M., Blyth, F. M., Main, C. J., Hush, J. M., Lo, S., & McAuley, J. H. (2019). Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients with Acute Low Back Pain: A Randomized Clinical Trial. JAMA neurology, 76(2), 161–169.
• Tüzün, F., Unalan, H., Oner, N., Ozgüzel, H., Kirazli, Y., Içağasioğlu, A., Kuran, B., Tüzün, S., & Başar, G. (2003). Multicenter, randomized, double-blinded, placebo-controlled trial of thiocolchicoside in acute low back pain. Joint bone spine, 70(5), 356–361.
• Uribe, A. A., Arbona, F. L., Flanigan, D. C., Kaeding, C. C., Palettas, M., & Bergese, S. D. (2018). Comparing the Efficacy of IV Ibuprofen and Ketorolac in the Management of Postoperative Pain Following Arthroscopic Knee Surgery. A Randomized Double-Blind Active Comparator Pilot Study. Frontiers in surgery, 5, 59.