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after surgery and 3 days after surgery.
Among other findings, the patients given ibuprofen fared significant-
ly better in just about every way and at every step along the way. They
had less pain, they were more upbeat, they slept better and they were
able to get back to normal activities faster. Additionally, while the
placebo group showed a spike in fatigue immediately after surgery,
the ibuprofen group had no change in fatigue. The only area in which
the ibuprofen group didn't show a benefit involved the ability to com-
municate with staff and to follow instructions. Here, there was no dif-
ference between the groups.
By measuring immune responses and production of cytokines, we
were able to show how the benefits are accrued. For example, ibupro-
fen suppressed the body's production of interleukin 10, an anti-inflam-
matory cytokine. In short, the hormonal responses to inflammation
were mitigated, which kept patients on a more even keel and a shorter
path to recovery.
Though the results of a Digits Span Forward and Backward test
were less striking, the ibuprofen group also appeared to have slightly
better cognitive function after surgery. That is, they were better able
to recite a sequence of numbers backwards. (There was no difference
in the ability to recite the sequence forward.)
Tamping down the stress response
The stress response to surgery is characterized by activation of the
sympathetic nervous system, increased secretion of pituitary hor-
mones, as well as the inflammatory response. This combined effect
may lead to a number of post-op complications as well as diminished
quality of recovery. Anti-inflammatory agents may decrease the activa-
tion of the stress response. We hypothesized that IV ibuprofen would
improve recovery characteristics.
