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Ibuprofen Oral Administration Protocols for Analgesia After Cesarean Delivery: A Prospective Randomized Controlled Study

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Objective: To compare the analgesic effects of ibuprofen administered orally via two modes combined with a conventional, patient-controlled intravenous analgesia pump on maternal pain after cesarean section (CS). Methods: This prospective, randomized, controlled study enrolled females who underwent CS from August 2022 to August 2023 at Peking University First Hospital, Beijing, China. The participants were randomly assigned to the as-needed group (ibuprofen administered orally if demanded) or the scheduled group (ibuprofen administered orally 6 hours postpartum at 12-hour intervals for 48 hours). The post-delivery pain scores, oxycodone consumption at different time points, time to exhaust, ambulation, and lactation initiation, analgesia satisfaction level, and depression scores were compared between the two groups using relevant statistical methods with IBM SPSS version 26. The level of significance was 0.05. Results: The scheduled group showed significantly better pain control at 12 hours (4.00 (2.00–5.50) vs. 4.00 (4.00–6.00), P < 0.001), 24 hours (4.00 (2.00–4.00) vs. 4.00 (2.00–6.00), P < 0.001), and 36 hours (2.00 (2.00–4.00) vs. 4.00 (2.00–4.00), P < 0.001), and 48 hours (2.00 (2.00–4.00) vs. 2.00 (2.00–4.00), P = 0.004) post-delivery and lower levels of oxycodone consumption at 36 hours (10.20 (8.20–13.35) vs. 11.00 (8.80–14.40), P = 0.042) and 48 hours (12.40 (10.40–15.95) vs. 13.80 (11.00–16.00), P = 0.020) postpartum compared with those in the as-needed group. Additionally, the time to the return of bowel movements was shorter in the scheduled group than in the as-needed group (23.50 (16.94, 31.47) vs. 27.00 (19.88, 35.97), P = 0.004). Differences in post-delivery ambulation, lactation initiation, satisfaction levels, and depression scores were not significantly different between the two groups. Conclusion: The results of this study promote the use of ibuprofen (scheduled oral administration) combined with a conventional, patient-controlled intravenous analgesia pump for achieving better post-CS pain control than an as-needed dosage regimen. Registration: Chinese Clinical Trial Registry, ChiCTR2400082474.

Source: Maternal-Fetal Medicine

DOI: 10.1097/fm9.0000000000000266