Ibuprofen may outperform Codeine for pain management after surgery

• Researchers demonstrate that Ibuprofen is much more effective than Codeine in managing pain after surgery.
• They also claim that Ibuprofen also has fewer side effects than Codeine, which is an opiate
• Experts say Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are not as addictive as Codeine.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen often provide better pain control and fewer side effects than Codeine after surgery.

That’s according to research published today in the Canadian Medical Association Journal.

The researchers said they found that people who took NSAIDs had lower pain levels than those who took Codeine 6 and 12 hours after surgery.

The study authors wrote: “In all surgical categories, subgroups, and outcomes, NSAIDs were equally or more effective in postoperative pain relief than Codeine.

They add: “We found that patients randomized to NSAIDs after outpatient surgery reported better pain, better overall score, fewer side effects, and fewer side effects. There was no difference in bleeding compared to those taking Codeine.”

What the studies reveal

Researchers looked at 40 randomized controlled trials (RCTs) of more than 5,100 adults to compare the safety of drugs containing Codeine and NSAIDs and their effectiveness in pain relief.

“We found high-quality evidence that postoperative outpatients taking NSAIDs reported less pain than those taking Codeine in a meta-analysis of RCTs,” the researchers wrote.

Dr Sean Mackey, chief of the division of pain management at Stanford University in California, said the study’s results were not surprising.

“I’m not surprised, but it’s nice to see some data coming out that corroborates that,” he told Healthline. “Postoperative pain is really no different from a controlled injury and part of the lesion causes an inflammatory response. NSAIDs have anti-inflammatory effects. They will reduce swelling and pain. They will be a good pain reliever. I can easily see that NSAIDs can be effective pain relievers for many types of surgery.”

How do pain relievers work?

Codeine belongs to a class of drugs known as opioids. Opioids work by changing how the nervous system and brain respond to pain.

“It’s a weak opioid. In the United States, we don’t use them for postoperative pain,” explains Mackey.

NSAIDs work by blocking an enzyme in the body that makes Prostaglandins. Prostaglandins are chemicals in the body that may play a role in inflammation and pain. Reducing the amount of Prostaglandins made in the body can help reduce inflammation and pain.

“In pain management after surgery, what we usually do is we will combine these drugs. So we’re going to use some NSAIDs and some opioids,” Mackey said.

Side effects comparison

Both NSAIDs and Codeine have potential side effects

In the Canadian study, researchers found that people who took NSAIDs after surgery had fewer side effects than those who took Codeine.

“The benefit of Codeine is as a pain reliever, although it is a rather weak pain reliever. Its downside is being an opioid, which has all the potential side effects of an opioid. Opioids cause constipation. They can cause itching, nausea, and vomiting. In sensitive people, they can slow your breathing,” says Mackey.

“Then there is always the potential for ‘abuse’ with opioid use. Exposure to opioids carries the risk of future abuse or “abuse.” It’s rare but it can happen,” he added.

NSAIDs also carry risks, but Mackey says they’re usually the safe ones.

“Clearly the downside is the inability to be abusive or addictive. You simply cannot be addicted to NSAIDs. They are generally safe, but they have some potential downsides. These include an increased risk of bleeding because they also inhibit your platelets from sticking together, so clotting function can be impaired after surgery by NSAIDs,” he says.

NSAIDs can also cause stomach irritation, and long-term use can also cause kidney damage, increase blood pressure, and increase cardiovascular events.

Although the Canadian study concluded that NSAIDs provide better pain control and fewer side effects after surgery than Codeine, Mackey said the results do not imply that the same can be said for other opioids.

“You are just comparing [NSAIDs với] an opioid here. You can’t generalize to morphine, hydrocodone, hydromorphone, fentanyl… any of those,” he noted.

Written by Elizabeth Pratt on June 14, 2021 — Fact checked by Maria Gifford

Source: Ibuprofen May Be Superior to Codeine to Manage Postsurgery Pain

Link: https://www.healthline.com/health-news/ibuprofen-may-be-superior-to-codeine-to-manage-postsurgery-pain

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Translated by: Danh Cuong