COMPARISON BETWEEN INTRAVENOUS ACETAMINOPHEN AND INTRAVENOUS IBUPROFEN FOR PAIN RELIEF AFTER CESAREAN SECTION

Alaa Al-Haq Majed Hasan* and Ahmad Yousef

ABSTRACT

Study Aim: To compare the effectiveness of intravenous acetaminophen with that of intravenous ibuprofen in pain management following cesarean sections. Material and Methods: Informed consent was obtained from all participants. Pregnant women undergoing cesarean section were prepared and necessary preoperative tests performed. Participants were randomized into two groups for postoperative analgesia: one group received 1000 mg of intravenous acetaminophen, while the other received 800 mg of intravenous ibuprofen. Each woman received a single dose of postoperative analgesia, in addition to intraoperative analgesia. Follow-up occurred during hospitalization, with pain scores recorded 6 hours’ post-surgery using the Wong-Baker Faces Pain Scale and FLACC. The timing of additional analgesia requests and length of hospital stay until discharge were documented, alongside the incidence and type of complications during the obstetric hospital stay. Results: The final sample consisted of 86 women, with 43 in the IV acetaminophen group and 43 in the IV ibuprofen group. The mean age of participants was 27.88 ± 5.41 years, with homogeneous age distribution. The mean gestational age was approximately 38.31 ± 1.1 weeks, with the first group averaging 38.4 ± 1.19 weeks and the second group 38.23 ± 1.0 weeks. Notably, 33 women (38.4%) had given birth to more than two children, while 32 women (37.2%) underwent their first cesarean section, and 32 had two or more previous cesarean deliveries. Pain assessment indicated that the simple pain category was predominant in both groups. The average pain score on the Wong-Baker Faces Pain Scale was 3.8 for the acetaminophen group and 2.4 for the ibuprofen group. For the FLACC index, average pain scores were 3.1 and 2 for the acetaminophen and ibuprofen groups, respectively, with no statistically significant difference noted. The time until additional analgesia was requested averaged 10.5 ± 7.3 hours in the acetaminophen group and 14.3 ± 8.3 hours in the ibuprofen group (P = 0.031), indicating a statistically significant difference. Mean hospitalization duration was 12.6 ± 4.9 hours for the acetaminophen group compared to 13.9 ± 5.1 hours for the ibuprofen group. Complications were recorded in only one patient in the acetaminophen group, who experienced postoperative vomiting, while six patients in the ibuprofen group encountered complications during follow-up. Conclusion: Both acetaminophen and ibuprofen provide effective options for postoperative analgesia, contributing to reduced overall opioid and central analgesic consumption. They are generally safe medications with minimal significant side effects

Keywords: Cesarean section, Acetaminophen, Ibuprofen.