The effects of pre-emptive intravenous ibuprofen on the thiol/disulfide
homeostasis and C-reactive protein level as the markers of oxidative
stress and inflammation during gynecologic laparoscopy: A randomized
clinical trial
Abstract
Aims: In this study, we aimed to investigate the anti-inflammatory and
antioxidant effects of intravenous ibuprofen by using the C-reactive
protein level and thiol/disulfide homeostasis as the oxidative stress
marker. Materials and Methods: This study was conducted on 70 patients
aged between 30and65 who were scheduled for elective laparoscopic
hysterectomy. The patients were divided into two groups to receive
either preemptive 800mg of intravenous ibuprofen plus 1000 mg of
intravenous paracetamol (Group IP) or only 1000 mg of intravenous
paracetamol as a control group (Group P).The blood samples for
thiol/disulfide homeostasis were collected as follows; before induction
of anesthesia (T0),before pneumoperitoneum (T1),following post-deflation
and discontinuation of anesthesia (T2) and postoperative 24th hour
(T3).Simultaneous blood samples for C-reactive protein were also
collected. The pre and postoperative urea, creatinine, alanine
aminotransferase (ALT), and aspartate aminotransferase (AST) levels were
measured. Results: A total of 69 patients were included in the study.
The patient’s characteristics and intraoperative variables were
comparable between groups (p>0.05). The number of patients
requiring rescue analgesia, the total amount of analgesic used, VAS
scores, and postoperative side effects were significantly lower in Group
IP (p<0.001).There decrease in native and total thiol levels
at T1, T2, T3 measurement points was significant in Group IP
(p<0.001). In both groups, the comparison to baseline values
demonstrated no significant changes in terms of disulfide level
(p>0.05).The simultaneous CRP levels indicated a
significant increase at the postoperative 24.hour in both groups
(p<0.001). The difference between groups was insignificant
(p>0.05). There was a significant increase in urea and
creatinine levels in patients of Group IP (p<0.05).
Conclusion: The pre-emptive administration of ibuprofen provided an
effective pain control after gynecologic laparoscopy. However, ibuprofen
changed the thiol/disulfide homeostasis in favor of oxidation and had no
beneficial effect in surgically induced oxidative stress.