Comparison of the analgesic effect of ibuprofen with mesalamine after discectomy surgery in patients with lumbar disc herniation: a double-blind randomized controlled trial.

BACKGROUND Pain management is an important component in the postoperative period following discectomy. AIMS We hypothesized that mesalamine considering its better safety profile, is likely to be a better choice, if it would be as effective as ibuprofen in controlling post-discectomy pain. SETTINGS AND DESIGN A double-blind randomized controlled trial was performed on patients who underwent lumbar discectomy surgery. MATERIALS AND METHODS Of the 58 patients who had lumbar discectomy, 27 patients were randomized to oral ibuprofen 500 mg and 31 patients to mesalamine 400 mg, three times a day for nine days following surgery. There was no placebo group. Severity of pain was assessed by using 10- cm visual analogue scale (VAS), once before operation and for nine days after. STATISTICAL ANALYSIS Mean +/- SD pain scores were compared between groups and the statistical difference was estimated by Student's test using SPSS (Version 13). We also calculated the power of each t-test. Repeated measure ANOVA was performed for measuring the effect of time. RESULTS The age range of the patients was 35 to 60 years (mean: 42.2 years). Mean +/- SD preoperative pain scores for ibuprofen or mesalamine-treated groups were 7.852 +/- 2.441 and 7.806 +/- 2.892, respectively. At the end of day 9, mean +/- SD of pain score was 2.704 +/- 2.284 and 2.717 +/- 2.273 for ibuprofen and mesalamine-treated groups respectively. Both drugs significantly reduced postoperative pain and there was no statistically significant difference between the two groups. CONCLUSIONS Since both drugs showed almost equal analgesic effect, considering its safety profile mesalamine, seems to be the preferred choice to alleviate post-discectomy surgery pain.