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.