Abstract
Purpose
This study was carried out to evaluate the postoperative analgesic effects of preoperative intravenous flurbiprofen in patients undergoing arthroscopic rotator cuff repair under general anesthesia.
Methods
We studied 44 patients who underwent an elective arthroscopic rotator cuff repair in a prospective, randomized, and double-blind fashion. The patients were divided into two groups. Group A (n = 22) received lipid emulsion 0.1 ml·kg−1 as a placebo, and group B (n = 22) received flurbiprofen 1 mg·kg−1 before the surgery. Intralipid or flurbiprofen was given intravenously 5 min before the surgery. General anesthesia was maintained with sevoflurane and nitrous oxide, and 10 ml of 0.75% ropivacaine was administered intraarticularly at the end of the surgery. Postoperative analgesia was supplied with intravenous 0.1 mg buprenorphine according to the patient’s demand. The effectiveness of flurbiprofen’s analgesic effect was measured by a visual analog scale (VAS) and by the amount of buprenorphine consumption at 0.5, 1, 2, 4, 6, 12, and 24 h after the surgery. Time to the first analgesic was also recorded.
Results
VAS in group B was significantly (P < 0.01) lower than that in group A during the first 6 h postoperatively. The amount of buprenorphine consumption in group B was also significantly (P < 0.01) less than that in group A within the first 2 h postoperatively. The time to first analgesic request in group B was significantly (P < 0.01) longer than that in group A.
Conclusion
These results show that preoperative intravenous flurbiprofen facilitates the analgesic effect in the early postoperative period after arthroscopic rotator cuff repair.
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References
Rodola F, Vagnoni S, D’Avolio S, Vurchio M, Micci D, Chierichini A, Vergari A, Ciano F. Intra-articular analgesia following arthroscopic surgery of the shoulder. Eur Rev Med Pharmacol Sci. 2001;5:143–146.
Tetzlaff JE, Dilger JA, Abate J, Parker RD. Preoperative intra-articular morphine and bupivacaine for pain control after outpatient arthroscopic anterior cruciate ligament reconstruction. Reg Anesth Pain Med. 1999;4:220–224.
Khoury GF, Chen AC, Garland DE, Stein C. Intraarticular morphine, bupivacaine, and morphine/bupivacaine for pain control after knee videoarthroscopy. Anesthesiology. 1992;77:263–266.
Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993; 77:1048–1056.
Task Force on Pain Management, Acute Pain Section. Practice guidelines for acute pain management in the perioperative setting. Anesthesiology. 1995;82:1071–1081.
Rosaeg OP, Krepski B, Cicutti N, Dennehy KC, Lui AC, Johnson DH. Effect of preemptive multimodal analgesia for arthroscopic knee ligament repair. Reg Anesth Pain Med. 2001;26:125–130.
Park KM, Lee MK, Hwang KJ, Kim CK. Phospholipid-based microemulsions of flurbiprofen by the spontaneous emulsification process. Int J Pharm. 1999;183:145–154.
Nakayama M, Ichinose H, Yamamoto S, Nakabayashi K, Satoh O, Namiki A. Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy. Can J Anaesth. 2001;48:234–237.
Tanaka S, Sonoda H, Nakabayashi K, Namiki A. Preoperative flurbiprofen provides pain relief after laparoscopic cholecystectomy. Masui. 1997;46:679–683.
Dionne RA. Suppression of dental pain by the preoperative administration of flurbiprofen. Am J Med. 1986;24:80:41–49.
Ong CK, Lirk P, Seymour RA, Jenkins BJ. The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg. 2005;100:757–773.
Franceschi F, Rizzello G, Cataldo R, Denaro V. Comparison of morphine and ropivacaine following knee arthroscopy. Arthroscopy. 2001;17:477–480.
Zink W, Graf BM. Benefit-risk assessment of ropivacaine in the management of postoperative pain. Drug Saf. 2004;27:1093–1114.
Hansen TG. Ropivacaine: a pharmacological review. Expert Rev Neurother. 2004;4:781–791.
Takada M, Fukusaki M, Yamashita K, Inadomi C, Takada M, Sumikawa K. Pre-administration of flurbiprofen suppresses prostaglandin production and postoperative pain in orthopedic patients undergoing tourniquet inflation. J Clin Anesth. 2007;19: 97–100.
Ochroch EA, Mardini IA, Gottschalk A. What is the role of NSAIDs in pre-emptive analgesia? Drugs. 2003;63:2709–2723.
Svensson CI, Yaksh TL. The spinal phospholipase-cyclooxy-genase-prostanoid cascade in nociceptive processing. Annu Rev Pharmacol Toxicol. 2002;42:553–583.
Cryer B, Feldman M. Cyclooxygenase-1 and cyclooxygenase-2 selectivity of widely used nonsteroidal anti-inflammatory drugs. Am J Med. 1998;104:413–421.
Parepally JM, Mandula H, Smith QR. Brain uptake of nonsteroidal anti-inflammatory drugs: ibuprofen, flurbiprofen, and indomethacin. Pharm Res. 2006;23:873–881.
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Takada, M., Fukusaki, M., Terao, Y. et al. Postoperative analgesic effect of preoperative intravenous flurbiprofen in arthroscopic rotator cuff repair. J Anesth 23, 500–503 (2009). https://doi.org/10.1007/s00540-009-0799-3
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DOI: https://doi.org/10.1007/s00540-009-0799-3