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Preoperative flurbiprofen axetil administration for acute postoperative pain: a meta-analysis of randomized controlled trials

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Abstract

Objective

Non-steroidal anti-inflammatory drugs have been shown to effectively decrease postoperative pain and reduce opioid requirements. Flurbiprofen axetil is an injectable non-selective cyclooxygenase inhibitor that has a high affinity for inflammatory tissues to achieve targeted drug therapy and prolonged duration of action. This meta-analysis examined the use of preoperative flurbiprofen axetil and its impact on postoperative analgesia.

Methods

An electronic literature search of the Library of PubMed, Cochrane CENTRAL, and EMBASE databases was conducted in Feb 2016. Searches were limited to randomized controlled trials. The primary outcome was pain scores. The secondary outcomes included cumulative postoperative opioid consumption and opioid-related adverse effects.

Results

A total of nine RCT studies involving 457 patients were included in this study. Compared to patients without perioperative flurbiprofen axetil, patients treated with preoperative flurbiprofen axetil had lower pain scores at 2 h (SMD −1.00; 95% CI −1.57 to −0.43, P = 0.0006), 6 h (SMD −1.22; 95% CI −2.01 to −0.43; P = 0.002), 12 h (SMD −1.19; 95% CI −2.10 to −0.28; P = 0.01), and 24 h (SMD −0.79; 95% CI −1.31 to −0.27; P = 0.003) following surgery. Preoperative flurbiprofen axetil had no significant effect on postoperative opioid consumption (SMD −13.11; 95% CI −34.56 to 8.33; P = 0.23). There was no significant difference between the groups with regard to adverse effects. Compared to patients with postoperative flurbiprofen axetil, however, preoperative flurbiprofen axetil resulted in decreased pain score only at 2 h after operation.

Conclusions

Preoperative use of flurbiprofen axetil will result in significantly lower postoperative pain scores, but no difference in nausea, vomiting, and opioid consumption compared to those who did not receive flurbiprofen axetil. However, more homogeneous and well-designed clinical studies are necessary to determine whether preoperative flurbiprofen axetil administration has more efficacy than that given at the end of surgery.

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Acknowledgements

This study was supported by Nature Science Foundation of Guangdong Province, China, Grant number 2015A030313781.

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Author notes

  1. Ke Wang and Jun Luo contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, Peking University Shenzhen Hospital, 1120 Lianhua Road, Shenzhen, 518036, Guangdong, People’s Republic of China

    Ke Wang, Limin Zheng & Tao Luo

  2. Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People’s Republic of China

    Jun Luo

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  1. Ke Wang
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  2. Jun Luo
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  3. Limin Zheng
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  4. Tao Luo
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Correspondence to Limin Zheng or Tao Luo.

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Wang, K., Luo, J., Zheng, L. et al. Preoperative flurbiprofen axetil administration for acute postoperative pain: a meta-analysis of randomized controlled trials. J Anesth 31, 852–860 (2017). https://doi.org/10.1007/s00540-017-2409-0

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  • DOI: https://doi.org/10.1007/s00540-017-2409-0

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