Why does the doctor ask you to take ibuprofen before surgery?

Anecdotally, I don’t have patients call me (and they get my cell number) needing extra medication after surgery and Ibuprofen 800mg preoperatively is why I believe that is so.  Mechanism is thought to be preventing prostaglandin formation leading to less pain and swelling.  My patients also rarely swell.  Ice helps that too.  I usually am asked by patients why I gave them a prescription for a narcotic since they didn’t need anything at all to manage pain after the procedure.

There are some articles that suggest little help in using Ibuprofen for General Surgery and that it might cause bleeding (aspirin does that and Tylenol is not anti-inflammatory) but I have seen no evidence of that.  Those are articles paid for by makers of Aleve (Naproxen).  However, ibuprofen is used extensively at 600-800mg preoperatively to reduce pain induced by wisdom tooth extraction, orthodontic treatment and operative dentistry.  Adult dosage is 400-600mg q4-6h or 800mg q8h.  I usually cut it back to 400mg or 600mg for children under 12 years.

I only use it for extractions and minor surgery in patients without stomach or GI disorders.  I have never heard of an ibuprofen allergy…

Look at these articles:

http://etd.fcla.edu/UF/UFE0004879/nekula_c.pdf
http://www.ajodo.org/article/S0889-5406(00)47811-X/abstract

http://jcp.sagepub.com/content/23/1/37.abstract

It is not effective long-term for in office bleaching sensitivity (which is why I don’t do in-office bleaching anyway):

http://iadr.confex.com/iadr/2008Toronto/techprogram/abstract_106126.htm

It does not effect other drugs we use for local anesthesia:

http://www.facebook.com/note.php?note_id=315130634474

Finally, here is the keystone article from back in 1978:

Evaluation of preoperative ibuprofen for postoperative pain after removal of third molars

Thank you,

Dr. Philip Estes