Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review
Intravenously administered nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a crucial component of multimodal analgesia strategies in surgical settings. This narrative review aims to provide an up-to-date evaluation of the efficacy, safety, and clinical use of intravenous (IV) NSAIDs for per...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Pharmacy |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2226-4787/13/1/18 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849718957479559168 |
|---|---|
| author | Axel Maurice-Szamburski Cyril Quemeneur Romain Rozier Philippe Cuvillon Claude Ecoffey |
| author_facet | Axel Maurice-Szamburski Cyril Quemeneur Romain Rozier Philippe Cuvillon Claude Ecoffey |
| author_sort | Axel Maurice-Szamburski |
| collection | DOAJ |
| description | Intravenously administered nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a crucial component of multimodal analgesia strategies in surgical settings. This narrative review aims to provide an up-to-date evaluation of the efficacy, safety, and clinical use of intravenous (IV) NSAIDs for perioperative pain management in adults and children. The NSAIDs and selective COX-2 inhibitors (coxibs) approved in Europe for the short-term symptomatic treatment of acute, moderate perioperative pain via IV infusion in adults and/or children have been influenced by US and global guidelines and practice: the drugs primarily reviewed here are ibuprofen, ketorolac, ketoprofen, naproxen, paracetamol, and acetylsalicylic acid. Furthermore, intravenous ibuprofen is authorized for the short-term symptomatic treatment of fever. In contrast to intravenous ketoprofen, intravenous ibuprofen is authorized for administration to children over 6 years of age or weighing more than 20 kg. Overall, IV ibuprofen had a more favorable profile with regard to peri- and postoperative opioid sparing and pain relief. Oral ibuprofen and IV ibuprofen have similar levels of efficacy, although IV ibuprofen has a shorter onset of action and is required in patients who are unable to take oral medications. The frequency of significant adverse events appears to be similar for ibuprofen and paracetamol. Systematic reviews and meta-analyses report that intravenous NSAIDs reduce postoperative opioid consumption by approximately 20–60%, improving pain management with fewer opioid-related side effects. In indications in infants, the choice of medication is limited, and the oral route is not always feasible; IV formulations of ibuprofen are preferred in this setting. Topics for further research should include head-to-head trials of IV NSAIDs. |
| format | Article |
| id | doaj-art-49bc0468dba24a74b84d21c18036ba2d |
| institution | DOAJ |
| issn | 2226-4787 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacy |
| spelling | doaj-art-49bc0468dba24a74b84d21c18036ba2d2025-08-20T03:12:15ZengMDPI AGPharmacy2226-47872025-02-011311810.3390/pharmacy13010018Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative ReviewAxel Maurice-Szamburski0Cyril Quemeneur1Romain Rozier2Philippe Cuvillon3Claude Ecoffey4Department of Anesthesiology and Critical Care, Pasteur University Hospital, 06300 Nice, FranceClinique Drouot Sport, 75009 Paris, FranceDepartment of Anesthesiology and Critical Care, L’Archet University Hospital, 06200 Nice, FranceDepartment of Anesthesiology, Intensive Care and Perioperative Medicine, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nimes, University Montpellier, 30908 Nimes, FranceDepartment d’Anesthésie Réanimation and Médecine Péri Opératoire, Hôpital Pontchaillou, Université Rennes, 35000 Rennes, FranceIntravenously administered nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a crucial component of multimodal analgesia strategies in surgical settings. This narrative review aims to provide an up-to-date evaluation of the efficacy, safety, and clinical use of intravenous (IV) NSAIDs for perioperative pain management in adults and children. The NSAIDs and selective COX-2 inhibitors (coxibs) approved in Europe for the short-term symptomatic treatment of acute, moderate perioperative pain via IV infusion in adults and/or children have been influenced by US and global guidelines and practice: the drugs primarily reviewed here are ibuprofen, ketorolac, ketoprofen, naproxen, paracetamol, and acetylsalicylic acid. Furthermore, intravenous ibuprofen is authorized for the short-term symptomatic treatment of fever. In contrast to intravenous ketoprofen, intravenous ibuprofen is authorized for administration to children over 6 years of age or weighing more than 20 kg. Overall, IV ibuprofen had a more favorable profile with regard to peri- and postoperative opioid sparing and pain relief. Oral ibuprofen and IV ibuprofen have similar levels of efficacy, although IV ibuprofen has a shorter onset of action and is required in patients who are unable to take oral medications. The frequency of significant adverse events appears to be similar for ibuprofen and paracetamol. Systematic reviews and meta-analyses report that intravenous NSAIDs reduce postoperative opioid consumption by approximately 20–60%, improving pain management with fewer opioid-related side effects. In indications in infants, the choice of medication is limited, and the oral route is not always feasible; IV formulations of ibuprofen are preferred in this setting. Topics for further research should include head-to-head trials of IV NSAIDs.https://www.mdpi.com/2226-4787/13/1/18NSAIDdiclofenacibuprofenketoprofenparacetamolacetaminophen |
| spellingShingle | Axel Maurice-Szamburski Cyril Quemeneur Romain Rozier Philippe Cuvillon Claude Ecoffey Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review Pharmacy NSAID diclofenac ibuprofen ketoprofen paracetamol acetaminophen |
| title | Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review |
| title_full | Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review |
| title_fullStr | Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review |
| title_full_unstemmed | Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review |
| title_short | Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review |
| title_sort | intravenously administered nonsteroidal anti inflammatory drugs in clinical practice a narrative review |
| topic | NSAID diclofenac ibuprofen ketoprofen paracetamol acetaminophen |
| url | https://www.mdpi.com/2226-4787/13/1/18 |
| work_keys_str_mv | AT axelmauriceszamburski intravenouslyadministerednonsteroidalantiinflammatorydrugsinclinicalpracticeanarrativereview AT cyrilquemeneur intravenouslyadministerednonsteroidalantiinflammatorydrugsinclinicalpracticeanarrativereview AT romainrozier intravenouslyadministerednonsteroidalantiinflammatorydrugsinclinicalpracticeanarrativereview AT philippecuvillon intravenouslyadministerednonsteroidalantiinflammatorydrugsinclinicalpracticeanarrativereview AT claudeecoffey intravenouslyadministerednonsteroidalantiinflammatorydrugsinclinicalpracticeanarrativereview |