Nav: Home

Ibuprofen doesn't increase bleeding risk after plastic surgery

March 31, 2016

March 31, 2016 - Patients are often instructed not to take ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) before or after surgery because of increased bleeding risk. But available evidence suggests that ibuprofen does not increase the risk of bleeding after plastic surgery procedures, according to a research review in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"Ibuprofen is a useful medication in the setting of surgery with multiple beneficial effects," write Drs. Brian Kelley, Jeffrey Kozlow and colleagues of the University of Michigan. They believe that ibuprofen may provide safe and effective pain control for selected plastic surgery procedures, while avoiding the higher risks and costs of some other pain medications.

Plastic Surgery Studies Report No Increase in Bleeding with Ibuprofen

The researchers performed a systematic review and meta-analysis of the research literature to identify high-quality studies comparing ibuprofen with other pain medications for patients undergoing plastic surgery-related operations. They found four studies in which 443 patients were randomly assigned to ibuprofen or other medications. All studies started ibuprofen either before or immediately after surgery, and continued for at least one week.

The procedures studied were cosmetic facial surgery, breast cancer surgery, hernia repair, and skin cancer surgery and reconstruction. All studies used the same ibuprofen dose (400 mg every four hours). Comparison treatments included acetaminophen, acetaminophen plus codeine, or the prescription-only NSAID ketorolac.

All of the study medications provided good pain control, the assembled data suggested. Only seven percent of patients assigned to ibuprofen and 11 percent assigned to comparison drugs reported dissatisfaction with their pain treatment. (The difference was not significant.)

Ibuprofen and other treatments were also similar in terms of bleeding risk. Rates of "surgically significant postoperative bleeding" were 3.5 percent with ibuprofen and 4.1 percent with other treatments (also nonsignificant).

A further analysis focused on the comparison between ibuprofen and acetaminophen plus codeine--a common postoperative pain medication that was used as a comparison treatment in three of the four studies. Again, there was no significant difference in pain control or bleeding risk.

"Bleeding is a significant concern for plastic surgeons and NSAIDs are routinely held with this in mind," Dr. Kelley and coauthors write. Even though ibuprofen is an inexpensive drug that is widely available over-the-counter (OTC), few studies have evaluated its use in plastic surgery patients.

The researchers emphasize that their study was limited to procedures where bleeding and hematomas (collections of blood) are easily detectable. They also acknowledge some other key limitations, particularly the small numbers of studies and patients included.

However, they believe that for plastic and dermatologic (skin) surgery procedures involving small areas, ibuprofen can provide good pain control without increasing bleeding risk. The findings are consistent with the fact that, in contrast to some other NSAIDs, ibuprofen has only short, temporary effect on the function of platelets--blood cells that play a key role in clotting.

Considering ibuprofen and other alternative medications is especially important given the rising concern about misuse or prescription opioid pain relievers, in addition to their high costs. Dr. Kelley and colleagues add, "OTC analgesics like ibuprofen are more cost effective given their effectiveness in pain control, well-established public tolerance, and low-risk qualities for abuse."
-end-
Click here to read "Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis."

Article: "Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis" (doi: 10.1097/PRS.0000000000002027)

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery® (http://journals.lww.com/plasreconsurg/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

For more information about our products and organization, visit http://www.wolterskluwerhealth.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Acetaminophen Articles:

Acetaminophen: A viable alternative for preventing acute mountain sickness
Trekking and mountain climbing are quickly growing in popularity, but.one of the challenges that climbers face is acute mountain sickness (AMS).
p53 critical to recovering from acetaminophen overdose
A new study shows that after an acetaminophen overdose, the p53 protein plays a key role in preventing the progression of liver damage and signaling the liver to repair itself.
Protein involved in blood clotting stimulates liver repair
A team of Michigan State University researchers, led by James Luyendyk in the College of Veterinary Medicine, has uncovered a new pathway in the body that stimulates liver repair.
Longer use of pain relievers associated with hearing loss in women
The new study adds to a growing body of evidence linking the use of NSAIDS or acetaminophen with loss of hearing.
Virtual liver model could help reduce overdose risk from acetaminophen, other drugs
Researchers at Indiana University's Biocomplexity Institute have developed a virtual model of the human liver to better understand how the organ metabolizes acetaminophen, a common non-prescription painkiller and fever-reducer used in over-the-counter drugs such as Tylenol.
You want shorter ER stays? Bring in the nurses
Protocols allowing nurses to administer certain types of treatment in the emergency department can dramatically shorten length of stay for patients with fever, chest pain, hip fractures and vaginal bleeding during pregnancy, according to the results of a study published earlier this month in Annals of Emergency Medicine ('A Pragmatic Randomized Evaluation of a Nurse-Initiated Protocol to Improve Timeliness of Care in an Urban Emergency Department').
Study shows acetaminophen can be tolerated by children with mild, persistent asthma
New study finds young children with mild, persistent asthma, can tolerate acetaminophen without the worsening of asthma, when compared with ibuprofen use.
Study shows acetaminophen can be tolerated by young children with mild, persistent asthma
In a study of children with mild, persistent asthma, scientists found that acetaminophen was tolerated without the worsening of asthma, when compared with ibuprofen use.
Acetaminophen does not aggravate children's asthma
Contrary to earlier reports, giving acetaminophen (Tylenol, etc.) for pain and fever does not worsen asthma in young children with the condition, concludes a randomized trial in the Aug.
Is acetaminophen use when pregnant associated with kids' behavioral problems?
Using the common pain-relieving medication acetaminophen during pregnancy was associated with increased risk for multiple behavioral problems in children, according to an article published online by JAMA Pediatrics.

Related Acetaminophen Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...