Ready to Use Intravenous Ibuprofen in Adult and Paediatric Multimodal Perioperative Analgesia: European Clinical Expert Opinion.

Despite the increasing availability of IV analgesics, perioperative pain management remains a challenge, especially in pediatric care where most IV NSAIDs do not have labelled indications. NSAIDs are consistently identified as essential for multimodal analgesia protocols. This document summarizes key discussions of a 2023 Medical Advisory Board Meeting (Frankfurt, Germany) on Ready-to-use (RTU) IV Ibuprofen, complemented by follow-up clinician questionnaires describing institutional clinical protocols, perceived benefits and safety considerations. Ready-to-use IV ibuprofen has become available in Europe in the last few years, prior to its worldwide launching. This paper aims to provide valuable insights and serve as a reference point for the introduction of this new formulation by colleagues in other countries. Ibuprofen inhibits COX-1 and COX-2 enzymes with a favorable COX-1/COX-2 ratio, reducing side effects. Its pharmacokinetics are consistent across age groups, and it is considered safe for pediatric and elderly populations. Experts reported broad adoption of RTU IV Ibuprofen across multiple surgical settings, with consistent analgesic efficacy and evident opioid-sparing effects. Protocols referred by the authors included mainly preemptive analgesia and multimodal strategies tailored to patient needs. Reported advantages for IV Ibuprofen included rapid onset of action, accurate dosing, faster recovery, and workflow benefits from a premixed preparation, making it suitable for hospitalized patients. Contraindications include allergies, active bleeding, and severe renal failure. Board members reported no increased bleeding risk in their experience with IV Ibuprofen.