Efficacy of acetaminophen versus ibuprofen for the management of rotator cuff-related shoulder pain: Randomized open-label study

Abstract

BackgroundShoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. However, data allowing comparison of the efficacy of these two drugs are very limited. We compared the therapeutic outcomes of acetaminophen and ibuprofen in the management of RC-related pain.MethodsThis was an open-label, two-center, active-control, prospective randomized clinical trial. Participants were assigned randomly to acetaminophen or ibuprofen treatment groups. The acetaminophen dose was 500 mg every 6–8 h, and it was 400–800 mg every 6–8 h for ibuprofen. The impact of the treatment was measured by Shoulder Pain and Disability Index (SPADI), Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires at baseline and after 6 weeks of therapy.ResultsThirty-three patients completed the study; 20 treated with ibuprofen and 13 with acetaminophen. Patients in both groups were comparable at baseline with regard to SPADI, Quick-DASH, and WHOQOL-BREF scores. After 6 weeks of treatment, patients receiving ibuprofen, but not acetaminophen, reported an improvement in pain severity and functional activity (as measured by SPADI and Quick-DASH). Patients taking acetaminophen, but not ibuprofen, reported improvement in the physical and environmental domains of WHOQOL-BREF scores.ConclusionsIbuprofen and acetaminophen provide benefits to patients suffering from RC-related pain. However, the type of improvement perceived by patients differed between these two medications.

The Safety Assessment of Irrigation Fluid Management for Shoulder Arthroscopy and Its Effect on Postoperative Efficacy

“…Therefore, in terms of postoperative analgesia, more consideration should be given to treatments to eliminate local inflammation (ice pack cold compress, non‐steroidal anti‐inflammatory drugs, etc. ), rather than relying on the dehydrating agent 20,27–30 …”

“…), rather than relying on the dehydrating agent. 20,[27][28][29][30] Although the local tissue swelling caused by fluid extravasation always disappear in a short period of post operation, the authors found that the amount of fluid extravasation was negatively correlated with the ASES score after 3 months of post operation and had no correlation with the ASES score after postoperative 6 months. Therefore, the extravasation fluid showed a continuous effect on muscle tissue, which would lead to changes in ADL parameters and affecting the ASES score.…”

Pengaruh Analgesik Terhadap Intensitas Nyeri Penderita Low Back Pain Pada Poli Orthopedi RSUP DR.M.Djamil Padang

“…Perbedaan bermakna juga diperlihatkan antara respon pengobatan 24 jam dan selisih nilai nyeri parsetamol 2 minggu dengan 4 minggu dengan nilai 0.024 (p<0.05) dan p 0.001<0.05. hal ini memperlihatkan bahwa natrium diklofenak dan parasetamol efektif sebagai analgesik pada penderita LBP. Suatu penelitian menyebutkan ibuprofen dan parasetamol sangat bermanfaat jika diberikan pada pasien dengan nyeri punggung, namun perbaikan keluhan yang dirasakan pasien berbeda antara kedua obat tersebut (AlRuthia et al, 2019).…”

“…Penelitian lain menyebutkan bahwa perbandingan efektivitas antara parasetamol dan ibuprofen masih sulit untuk dipahami, ibuprofen tampaknya lebih baik menangani masalah yang berhubungan dengan persepsi nyeri dan akibatnya, fungsi ekstremitas atas sedangkan pemberian parasetamol menghasilkan indeks yang lebih baik untuk kualitas (AlRuthia et al, 2019). Berbeda dengan parasetamol, NSAID seperti ibuprofen menghambat sensitisasi reseptor nyeri dengan cara menghalangi kaskade inflamasi (Rainsford,2013), sebaliknya mekanisme aksi parasetamol bersifat kompleks dan mencakup efek perifer (penghambatan COX) dan sentral (penurunan serotonergik jalur saraf, jalur L-arginin/nitrat oksida dan sistem cannabinoid) proses antinociception (Jozwiak-Bebenista & Nowak, 2014).…”