Comparison of Intravenous Ibuprofen and Paracetamol for Postoperative Pain Relief in Functional Endoscopic Sinus Surgeries: A Randomised Controlled Study

Introduction: Functional Endoscopic Sinus Surgery (FESS) is widely performed for chronic rhinosinusitis and sinonasal disorders. Despite being minimally invasive, it can cause moderate to severe postoperative pain, necessitating effective analgesia with minimal opioid use. Aim: To compare the efficacy of intravenous (i.v.) ibuprofen and i.v. paracetamol for postoperative pain management in patients undergoing FESS. Materials and Methods: This double-blind, randomise, controlled study was conducted at SRM Medical College Hospital and Research Centre in Chennai, Tamil Nadu, India done from 15th November 2024 and 2nd February 2025. It included 100 adult patients undergoing elective FESS under general anaesthesia. Patients were divided into two groups (n=50 each) to receive either i.v. ibuprofen (400 mg) (group I) or i.v. paracetamol (1 g) (group P), 30 minutes before the end of surgery. Postoperative pain intensity was assessed using the Visual Analogue Scale (VAS) score at 0, 4, 8, 12, 16, 20, and 24 hours. Secondary outcomes included total rescue opioid (i.v. tramadol) consumption, rescue analgesia requirement. Results were considered significant if ‘p’ was less than 0.05 (two-tailed). The analysis was done using IBM Statistical Package for Social Sciences (SPSS) version 21.0. Results: The baseline characteristics of groups I and P were comparable, with no significant differences observed across age (p-value=0.956), gender distribution (p-value=0.229), and weight (p-value=0.651). The ibuprofen group had significantly lower Non Steroidal Anti-Inflammatory Drugs (NSAIDs) requirements at 4, 8, 16, and 20 hours postoperatively (p-value <0.0001). Only 8% of patients in the ibuprofen group required rescue analgesia compared with 36% in the paracetamol group (p-value=0.001). Conclusion: The i.v. ibuprofen provides superior early postoperative analgesia compared to i.v. paracetamol in FESS patients, with reduced need for rescue opioids and better patient satisfaction, makes it a valuable choice in opioid-sparing pain management protocols.