Effects of scheduled ibuprofen combined with diclofenac suppository on postoperative pain in children undergoing pectus excavatum correction: a randomized controlled trial
- 1Department of Anesthesiology, Shanghai Children’s Hospital, Shanghai JiaoTong University
- 2Department of Thoracic Surgery, Shanghai Children’s Hospital, Shanghai JiaoTong University
Abstract
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for postoperative acute pain management. However, the safety and efficacy of postoperative scheduled oral ibuprofen remain unclear in children. The purpose of this study was to evaluate the efficacy and safety of scheduled ibuprofen combined with diclofenac suppository for postoperative analgesia in children following the Nuss procedure for pectus excavatum.
Methods: Sixty patients who underwent the Nuss procedure from September 2024 to August 2025 were randomly divided and assigned to either the experimental or control group. The experimental group received scheduled ibuprofen combined with a diclofenac suppository, whereas the control group received a diclofenac suppository and ibuprofen on demand. The postoperative visual analog scale (VAS) scores, supplemental opioid consumption, time to first ambulation, length of hospital stay, and incidence of adverse events were recorded for both groups.
Results: The VAS scores at 6–24 h postoperatively were significantly lower for the experimental group than the control group ( p < 0.05). The experimental group required less opioids than the control group (62.4 ± 5.7 vs. 67.5 ± 6.4 µg, p = 0.002; difference: −5.167 µg, 95% confidence interval: −8.325 to −2.008). Additionally, the time to first ambulation (5.9 ± 0.6 vs. 6.4 ± 0.7 h, p = 0.005; difference: −0.486 h, 95% confidence interval: −0.924 to −0.076) and length of hospital stay (6.8 ± 0.8 vs. 7.3 ± 0.8 days, p = 0.022; difference: −0.500 days, 95% confidence interval: −0.924 to −0.076) were shorter for the experimental group than the control group. The incidence of adverse events was similar for both groups ( p > 0.05).
Conclusion: This study indicates that scheduled ibuprofen combined with diclofenac suppository provides effective analgesia following the Nuss procedure, reduces opioid consumption, and promotes recovery. No serious NSAID-related adverse events were observed during the short postoperative observation period. However, the study was not powered to establish safety or exclude clinically important differences in uncommon adverse events.
Clinical Trial Registration: https://www.chictr.org.cn/ , identifier ChiCTR2400089927.
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BibTeX
@article{jiang2026effects,
title = {{Effects of scheduled ibuprofen combined with diclofenac suppository on postoperative pain in children undergoing pectus excavatum correction: a randomized controlled trial}},
author = {Yan Jiang and Lihong Chen and Jia Li and Junli Dong},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1901666},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1901666/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of scheduled ibuprofen combined with diclofenac suppository on postoperative pain in children undergoing pectus excavatum correction: a randomized controlled trial
AU - Yan Jiang
AU - Lihong Chen
AU - Jia Li
AU - Junli Dong
PY - 2026
DA - 2026/10/28
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1901666
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1901666/full
AB - Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for postoperative acute pain management. However, the safety and efficacy of postoperative scheduled oral ibuprofen remain unclear in children. The purpose of this study was to evaluate the efficacy and safety of scheduled ibuprofen combined with diclofenac suppository for postoperative analgesia in children following the Nuss procedure for pectus excavatum. Methods: Sixty patients who underwent the Nuss procedure from September 2024 to August 2025 were randomly divided and assigned to either the experimental or control group. The experimental group received scheduled ibuprofen combined with a diclofenac suppository, whereas the control group received a diclofenac suppository and ibuprofen on demand. The postoperative visual analog scale (VAS) scores, supplemental opioid consumption, time to first ambulation, length of hospital stay, and incidence of adverse events were recorded for both groups. Results: The VAS scores at 6–24 h postoperatively were significantly lower for the experimental group than the control group ( p < 0.05). The experimental group required less opioids than the control group (62.4 ± 5.7 vs. 67.5 ± 6.4 µg, p = 0.002; difference: −5.167 µg, 95% confidence interval: −8.325 to −2.008). Additionally, the time to first ambulation (5.9 ± 0.6 vs. 6.4 ± 0.7 h, p = 0.005; difference: −0.486 h, 95% confidence interval: −0.924 to −0.076) and length of hospital stay (6.8 ± 0.8 vs. 7.3 ± 0.8 days, p = 0.022; difference: −0.500 days, 95% confidence interval: −0.924 to −0.076) were shorter for the experimental group than the control group. The incidence of adverse events was similar for both groups ( p > 0.05). Conclusion: This study indicates that scheduled ibuprofen combined with diclofenac suppository provides effective analgesia following the Nuss procedure, reduces opioid consumption, and promotes recovery. No serious NSAID-related adverse events were observed during the short postoperative observation period. However, the study was not powered to establish safety or exclude clinically important differences in uncommon adverse events. Clinical Trial Registration: https://www.chictr.org.cn/ , identifier ChiCTR2400089927.
SN - 1663-9812
ER -