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Effect of combination of paracetamol (acetaminophen) and ibuprofen vs either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty: The PANSAID randomized clinical trial

JAMA Feb 16, 2019

Thybo KH, et al. - A sum of 556 individuals were randomized to assess the impact of a combination of paracetamol (PCM) (acetaminophen) and ibuprofen (IBU) vs either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty (THA). They noted median 24-hour morphine consumption, 20 mg in the PCM + IBU group, 36 mg for PCM alone, 26 mg for IBU alone, and 28 mg for high strength (HS)–PCM + IBU. They found 15%, the proportion of subjects with serious adverse events (SAEs) in groups receiving IBU, and 11% in the PCM-alone group with a relative risk of SAE, 1.44. They reported no statistically significant improvement in SAEs in the pooled groups receiving IBU alone vs with PCM alone. They suggested IBU alone, a reasonable choice for early postoperative oral analgesia.
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