IV Ibuprofen Reduces Postoperative Pain and Opioid Use in Older Adults: Study

A new study published in the journal of Clinical Therapeutics showed that intravenous (IV) ibuprofen significantly reduced postoperative pain and opioid consumption in older adults. This research analyzed data from 4 clinical trials (2 placebo-controlled phase 3 studies and 2 open-label phase 4 trials) involving hospitalized patients treated for pain and/or fever. The findings support the safety and efficacy of IV ibuprofen in managing pain in older adults.

In contrast to younger adults, people 60 years of age and older report higher prevalence and intensity of pain and are more likely to need analgesic therapies for the treatment of both acute and chronic pain. These factors make managing postoperative pain in older adults more complicated because they are more sensitive to opioid analgesics, have a higher risk of side effects, and are more likely to develop postoperative delirium.

Although intravenous ibuprofen (IVIB) has been demonstrated to be safe and effective in both adult and pediatric populations, older people have not yet had its safety and effectiveness properly assessed. Thus, this study evaluated the safety and effectiveness of IVIB in patients who were 60 years of age or older.

The data from 4 prospective clinical trials that used IVIB to treat fever and/or pain in hospitalized patients every 6 hours for a maximum of 5 days were subjected to a post hoc subgroup analysis. The visual analogue scale for measuring pain and the total morphine demand were used to evaluate efficacy. 

Of the 1041 patients treated, 284 patients were aged 60 and above, of whom 223 received IV ibuprofen and 61 received a placebo, 757 were between the ages of 18 and 59. The effectiveness analysis comprised 591 participants from 2 placebo-controlled studies, whereas the safety evaluation covered all patients. The incidence of major adverse events (AEs) was comparable across treatment groups in both age cohorts, although the incidence of AEs was greater in the placebo group.

When compared to placebo, IVIB therapy reduced pain in older patients by 24.0% at rest (P = 0.008), 20.0% during movement (P = 0.001) between 6 and 24 hours after surgery, and 23.2% during total morphine demand (P = 0.031). Overall, elderly are more likely than younger adults to have pain and to experience adverse events, poor outcomes, and mortality from using specific pain drugs. 

Reference:

Gan, T. J., Gibson, B., Durr, E., Abad, A., Zaborny, B., Bergese, S., & Southworth, S. (2025). The safety and efficacy of intravenous ibuprofen in older patients: A retrospective subgroup analysis. Clinical Therapeutics. https://doi.org/10.1016/j.clinthera.2025.04.021