Efficacy of an intravenous acetaminophen/ibuprofen fixed-dose combination after total knee arthroplasty

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BACKGROUND: This study aimed to evaluate the efficacy of the intravenous fixed-dose combination (IV FDC) of acetaminophen and ibuprofen after total knee arthroplasty (TKA). METHODS: We retrospectively analyzed TKA patients, dividing them into control and IV FDC groups using 1:1 propensity matching based on age and sex. The primary outcome was the Visual Analog Scale (VAS) score at 8 h, 16 h, 24 h, 48 h, 72 h, 96 h, and 120 h postoperatively. Secondary outcomes included opioid consumption, conversion to Morphine Milligram Equivalents (MME), and complications requiring additional consultations with other departments. RESULTS: A total of 70 patients were included in each group after propensity matching. The IV FDC group had significantly lower VAS scores at 96 h (3.1 ± 0.7 vs. 3.5 ± 1.3, p = 0.033) and 120 h (3.1 ± 0.8 vs. 3.7 ± 1.4, p = 0.003) compared to the control group. Opioid consumption was also significantly lower in the IV FDC group compared to the control group, both on POD 1 (51.9 ± 41.0 vs. 82.5 ± 64.3, p < 0.001) and in total consumption (131.9 ± 92.5 vs. 175.2 ± 129.3, p = 0.025). CONCLUSION: The use of an IV FDC of acetaminophen and ibuprofen after TKA significantly reduced opioid consumption and demonstrated a modest improvement in pain scores at later postoperative time points.

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