Parenteral ibuprofen as part of multimodal analgesia for postoperative pain: clinical place, evidence base, and safety

Obstetrician-gynecologist, Oncogynecologist, Oncologist, Orthopaedic Trauma, Surgeon, The anesthesiologist and specialist on medical emergency conditions, Urologist
Parenteral ibuprofen as part of multimodal analgesia for postoperative pain: clinical place, evidence base, and safety

Abstract. Postoperative pain remains one of the factors shaping the early postoperative course, as it affects mobilization, respiratory function, quality of recovery, and the need for opioid analgesics.

Multimodal analgesia is based on the combination of drugs and techniques with different mechanisms of action, allowing both peripheral and central components of pain formation to be targeted while reducing opioid burden.

Parenteral ibuprofen is a nonsteroidal anti-inflammatory drug; its action is associated with cyclooxygenase inhibition and decreased prostaglandin synthesis. This provides a rationale for its use in the nociceptive-inflammatory component of postoperative pain. Intravenous administration is clinically relevant in the early postoperative period, when oral intake is temporarily impossible or insufficiently predictable.

The value of the drug is determined not by replacement of other analgesics, but by its possible inclusion in a multimodal regimen after assessment of gastrointestinal, renal, cardiovascular, and bleeding risks.

This article reviews the pathophysiological rationale for parenteral ibuprofen, clinical evidence for its opioid-sparing effect, safety issues, comparison with other parenteral NSAIDs, and its possible place in Ukrainian practice of postoperative pain management.

Keywords: postoperative pain; multimodal analgesia; parenteral ibuprofen; NSAIDs; nociception; prostaglandins; opioid-sparing effect; analgesic safety.

Authors:

  • Ivan Ivanovych Lisnyy, MD, DSc, PhD, Professor, Head of the Scientific Research Department, Department of Anesthesiology and Intensive Care, Surgery Center, National Cancer Institute.

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5 November, 2026

Authors:

Ivan Ivanovych Lisnyy

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Ibuflex / Ibuflex VEO

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