Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

Abstract

GENERAL ANESTHESIAPurpose: To assess whether perioperative intravenous administration of flurbiprofen, a non-steroidal anti-inflammatory drug, reduced postoperative pain after abdominal hysterectomy.Methods: Forty-five patients undergoing abdominal hysterectomy were randomly assigned to one of three groups of equal size. A control group (CONT) received a placebo 30 min before and at the end of surgery. The other two groups, PRE and POST, received 1 mg·kg -1 flurbiprofen iv 30 min before and at the end of surgery, respectively. All patients received identical general and epidural anesthesia. Postoperatively, 50 mg diclofenac pr was given for pain relief on patient demand. One of the authors assessed pain using a 10 cm visual analog scale at rest and during coughing at the first request for diclofenac, and at 15, 24, 48, and 72 hr after surgery. The number of times diclofenac was required during the first 24 hr after surgery was also recorded.Results: The number of diclofenac requests in the PRE (1.8 ± 0.4) and POST groups (2.0 ± 0.4) were less than in the CONT group (3.0 ± 0.4). The PRE group showed lower visual analog scale at rest at 15 and 24 hr and on coughing at 24, 48, and 72 hr after surgery than the CONT and POST groups.Conclusion: Intravenous 1 mg·kg -1 flurbiprofen administered during anesthesia reduces postoperative rescue analgesic requirement after abdominal hysterectomy. Moreover, flurbiprofen is more effective when given before than after surgery.Objectif : Vérifier si l'administration intraveineuse périopératoire de flurbiprofène, un anti-inflammatoire non stéroïdien, réduit la douleur postopératoire d'une hystérectomie abdominale.Méthode : Quarante-cinq patientes devant subir une hystérectomie abdominale ont été réparties au hasard en trois groupes égaux. Un groupe témoin (TEM) a reçu un placebo, 30 min avant et à la fin de l'opération. Les deux autres groupes, PRE et POST, ont reçu 1 mg·kg -1 de flurbiprofène iv 30 min avant et à la fin de l'intervention, respectivement. Toutes les patientes ont reçu une anesthésie générale et épidurale identique. Après l'intervention, 50 mg de diclofénac pr ont été administrés sur demande comme analgésie. Un des auteurs a évalué la douleur en utilisant une échelle visuelle analogique de 10 cm, au repos et pendant la toux à la première demande de diclofénac et, puis à 15, 24, 48 et 72 h après l'opération. On a aussi noté le nombre de demandes de diclofénac pendant les 24 premières heures postopératoires.

Flurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in β-endorphin levels

“…Our previous study confirmed that preoperative administration of flurbiprofen axetil in patients scheduled to undergo thoracotomy exerts marked preemptive analgesic effects [4]. Prophylactic administration of this drug before operation can effectively reduce the degree of postoperative pain and the requirement for analgesic drugs [3,5]. NSAIDs and opioid drugs are known to possess synergistic analgesic effects.…”

Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

“…The improvement in pain control is likely the result of perioperative CoX inhibition. [12][13][14][15][16]19 Reduction of PG synthesis would be expected to diminish nociceptor sensitization and inflammatory responses that normally accompany movement and stretching of injured tissues. [25][26][27] The CoX selectivity of FA remains unclear, although it was Data are mean ± SD.…”

“…28 In the present study, the dose of FA was adopted on the basis of values reported in the literature. 13,14 Since the analgesic effect of FA usually begins 30 min after administration, with an elimination half-life of six hours, we administered FA 30 min before and six hours after skin incision in the FA group.…”

“…10,11 Flurbiprofen axetil (FA), a non-selective cyclooxygenase (CoX) inhibitor, is composed of emulsified lipid microspheres that have a high affinity to inflammatory tissues. 12 It was reported that preoperative administration of FA could reduce postoperative pain after hysterectomy, 13 pulpectomy, 14 laparoscopic cholecystectomy, 15 pediatric strabismus surgery, 12 and spinal fusion surgery. 16 Furthermore, flurbiprofen has been reported to protect against acute pancreatitis-associated lung injury and septic shock in rats.…”

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

“…before propofol injection [5]. Various propofol formulations in mixtures of medium-chain triglyceride (MCT) and long-chain triglyceride (LCT) (propofol MCT/LCT) induces less injection pain than the original propofol formulation (propofol LCT) [10], but even these trials could not completely abolish the pain.Flurbiprofen, a nonsteroidal antiinflammatory drug (NSAID), administered before surgery was reported to have a postoperative analgesic effect (i.e., preemptive analgesic effect) [11]. Therefore, if prior administration of flurbiprofen could decrease propofol injection pain, this method would have double benefits: decreased propofol injection pain and preemptive analgesia.…”