Is Ibuprofen Better than Opioid Pain Relief Post-Surgery?

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September 3, 2021 | chris

Opioids have long held their place as the most potent analgesics in medicine, but recent research shows that basic over-the-counter ibuprofen may be more effective than highly addictive painkillers after certain types of surgery. While opioids will always have medical applications in anesthesiology and acute pain management, experts are considering the benefits of nonsteroidal anti-inflammatory drugs (NSAIDs) as a safer and most beneficial option for post-procedure recovery.

NSAIDs vs. Opioids 

Both opioids and NSAIDs are used to manage pain, but they work differently in the body. Opioids are commonly prescribed painkillers that interact with opioid receptors on nerve cells and in the brain. They’re designed to be taken for a short period as directed by a physician but carry a high potential for misuse.

NSAIDs come in many different strengths and formulations but are most commonly known as aspirin and ibuprofen. They work by blocking pain-signaling molecules and reducing inflammation while carrying no risk of misuse. Other applications include reducing fevers and preventing blood from clotting.

New Findings

A meta-analysis study conducted 40 randomized controlled trials comparing 5,100 post-operative patients taking opioid painkiller codeine to those taking NSAIDs. Their pain levels were measured on a scale of 1 to 10, 10 being the most unbearable pain imaginable. The findings were surprising for many and showed that those taking NSAIDs reported more favorable pain scores 6 hours after surgery than those given codeine. Those taking NSAIDs were also linked with better health assessments six and 24 hours after surgery reporting fewer side effects and bleeding issues.

The study fails to specify the types of procedures the test subjects underwent, making the findings not applicable for all medical surgery. Nevertheless, physicians and pain management specialists agree that NSAIDs are very effective for minor procedures and are preferable to prescribing opioids. However, it’s not likely that patients who undergo open-chest surgery would do well with only ibuprofen. It’s also important to note that NSAIDs would not be recommended for patients with kidney damage, high blood pressure, or certain heart conditions.

Why did Non-Opioid Patients do Better?

More and more, researchers are finding that opioid pain management can make pain worse, especially over time, through a process called opioid-induced hyperalgesia. Taking opioids for more than 4 weeks post-op or injury can cause pain to increase due to the body losing its natural ability to soothe pain. It also impacts the body’s resiliency and ability to recovery because it develops a dependency on the analgesic properties of opioids, causing them to delay rehabilitation and require more opioid painkillers for longer. Along with the risk of misuse and addiction, this makes the medication not ideal for long-term use, particularly for patients recovering from injury or surgery. Unfortunately, when dealing with acute pain, many doctors still heavily prescribe highly addictive painkillers because they’re so commonplace, and patients expect something more potent than what’s available over the counter for their recovery.

With the opioid crisis continually becoming worse, Americans may find that surgeons and health providers may forego prescribing opioids for post-surgery recovery for minor procedures. When taking NSAIDs for pain instead of opioids, the most critical factor is to stick to a regimented schedule instead of waiting for pain during recovery; this makes ibuprofen surprisingly effective.

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