Strength and Limitations
To our best knowledge, this is the first comprehensive systematic review to summarize the efficacy and safety of IVIB for postoperative pain and fever management in adults, with thorough consideration on multiple- (Q6h or Q8h) or single- dosage of IVIB without limitation on surgery types. Considering the heterogeneity of pain intensity, we only synthesized the data except for non-molar surgery studies in efficacy evaluation. It could strengthen the applicability of our review findings to patients with differing illness in various clinical settings.
This study has several limitations. First, more than 70% of trials included fewer than 60 patients per group, which may bring imprecision in synthesized results and publication bias due to small sample size. Second, there were insufficient trials to preform funnel plot to evaluate the publication bias, which may result in downgrade in the certainty of evidence. Third, considering insufficient data in some outcome measures, we were unable to identify high homogenous through subgroup analyses. Future studies should focus on the appropriateness of oral versus intravenous ibuprofen, patients’ compliance and economic evaluation, as well as its rational use in pediatrics and the elderly.