Acetaminophen Plus Ibuprofen Linked to Less Morphine Use After Hip Arthroplasty

Acetaminophen Plus Ibuprofen Linked to Less Morphine Use After Hip Arthroplasty

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Use of acetaminophen plus ibuprofen — compared with acetaminophen alone — is associated with less morphine use following total hip arthroplasty, suggests a JAMA study.

Roughly 550 patients undergoing total hip arthroplasty were randomized to receive one of the following oral treatments:

  • Acetaminophen (1000 mg), ibuprofen (400 mg)
  • Acetaminophen (1000 mg), placebo
  • Ibuprofen (400 mg), placebo
  • Half-strength acetaminophen (500 mg), ibuprofen (200 mg)

Treatment was given 1 hour before surgery and every 6 hours afterward for 24 hours.

Median morphine consumption in the 24 hours after surgery was significantly lower with acetaminophen-ibuprofen, compared with acetaminophen monotherapy (20 mg vs. 36 mg). Meanwhile, the difference between acetaminophen-ibuprofen and ibuprofen monotherapy (20 mg vs. 26 mg) was not clinically meaningful.

Serious adverse events did not differ between acetaminophen monotherapy and ibuprofen monotherapy.

The authors note that while combination therapy did reduce postoperative morphine use, “ibuprofen alone may be a reasonable option for early postoperative oral analgesia.”

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