INTRODUCTION
Nonsteroidal anti-inflammatory drugs (NSAIDs) play key roles both
inpatient and outpatient postoperative pain and fever therapy (1).
Uncontrolled postoperative pain is a ”vital sign” since it leads to
discomfort and a variety of impacts that can have a negative impact on
perioperative outcomes (2). Unless contraindicated, acetaminophen and/or
NSAIDs are strongly recommended to be a part of multimodal analgesia for
the management of postoperative pain in patients according to clinical
practice guidelines (3, 4). Non-opioid analgesics are frequently used in
conjunction with opioid analgesics to treat postoperative pain. NSAIDs
or acetaminophen are acknowledged as beneficial adjuncts to opioids that
have the potential to significantly reduce the opioid consumption,
resulting in avoidance of opioid-related adverse events (AEs) (5, 6).
Previous systematic reviews revealed that NSAIDs could lessen the need
for patients to use opioids as rescue analgesia, lowering the frequency
and severity of opioid-induced adverse events (AEs) (7). Even though
oral NSAIDs or acetaminophen have been utilized in the hospital setting
for many years, a large percentage of patients are unable to take oral
medications owing to intubation, tonsil surgery, dysphagia, coma, or
unconsciousness (8, 9). In contrast to the oral formulations,
intravenous NSAIDs or acetaminophen can therefore be an appropriate
option to present a convenient and fast-acting analgesic, resulting in
rapid onset of pain relief and reduced time to maximal pain relief.
Ibuprofen is a non‐selective NSAID that inhibits cyclooxygenase enzymes,
reducing the formation of prostaglandins, which are responsible for
pain, fever, and inflammation at the site of injury or disease (10, 11).
Intravenous ibuprofen (IVIB) was approved for use in hospitals by the
U.S. Food and Drug Administration in 2009 for the treatment of mild to
moderate pain, moderate to severe pain when combined with the
administration of opioids, and the reduction of adult fever. Previously,
narrative reviews revealed that IVIB had a favorable safety profile and
pain control (12). Nevertheless, prior systematic reviews only focused
on the analgesic efficacy of single-dose IVIB (13, 14) and its use on
pain reduction after third molar surgery (15). There lacks comprehensive
synthesis evidence demonstrating the efficacy and safety of IVIB with
multiple- or single- dosage in the management of pain and fever since
the published body of knowledge on IVIB continues to grow.
Therefore, this study aimed to conduct a thorough systematic review and
meta-analysis to validate the application of IVIB in postoperative
analgesia and antipyretic management in adults, providing evidence-based
support for clinical decision-making.