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.