Giving drugs before surgery to reduce postoperative pain is nothing new. Using drugs before surgery to reduce the use of painkillers could be highly desirable. But does it work?

The authors of an article published in the current issue of the journal Anesthesia Progress discovered there is no benefit from the pre-operative use of ibuprofen and similar drugs in decreasing post-operative pain.

Dentists often prescribe oral drugs for post-operative pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are a popular option worldwide because they are common, cheap, and effective. When painkillers are given before surgery, they ideally reduce – or even prevent – the pain that is typically felt during and after an operation. When these drugs work, patients recover faster and get back to their daily activities more quickly.

In the studies, over-the-counter medications such as ibuprofen were given before oral surgery in an attempt to cut down prescription painkiller use afterward. The authors hoped that by systematically reviewing existing research, they could find out whether such pre-emptive efforts work.

The studies reported that giving ibuprofen before or after surgery resulted in the same levels of pain, facial edema, and limited mouth opening. Ketoprofen, another NSAID, was given at different dosages before surgery in different studies, but the results were the same.

The authors found it impossible to draw stronger conclusions because the timing, types of drugs and surgery, and use of other pain relief techniques varied so widely among the studies. They concluded that further careful clinical trials are required to provide solid information on this controversial topic.