Preoperative Intravenous Flurbiprofen As An Analgesic Adjunct After Abdominal Hysterectomy: The Effects On Effort-dependent Pain And Pulmonary Function

Objectives: To investigate whether perioperative intravenousadministration of Flurbiprofen, a non-steroidal anti-inflammatory drug,reduced postoperative pain after abdominal hysterectomy and examine itseffects on effort-dependent pain, postoperative Fentanyl citraterequirements and pulmonary function.Methods: 60 patients (from 38 to 55 years old, ASAⅠ～Ⅱ)undergoing elective abdominal hysterectomy were randomly divided into3 groups (n=20). Patients who suffered from chronic pain were excludedfrom the study.They were all intracheal intubated after the induction ofanesthesia with Midazolam (0.1mg/kg), Fentanyl (5μg/kg) andAtracuronium (0.6 mg/kg). Intermittent inspiration of Isoflurane andadministration of Atracuronium were adopted to maintenance andcontinuous pumping of Propofol to maintain BIS between 40～50. The Tgroup received 100 ml saline 30 min before and at the end of surgery.The PRE group received 1 mg·kg^-1flurbiprofen iv 30 min before surgeryand a placebo at the end of surgery. The POST group received a placebo30 min before surgery and Flurbiprofen at the erid of surgery.Flurbiprofen were mixed with 100 ml saline and given within 15 min.This test solution was prepared by one anesthesiologist, and anotheranesthesiologist who was blinded to the solution performed anesthesia. TheⅣ-patient-controlled analgesia(PCA) device was programmed withFentanyl to provide a 1-ml bolus dose with a lockout interval of 6 minand a 1-h limit of 0.15 mg. The total Fentanyl dosage, the number ofbutton pressed (Bolus), the pain intensity at rest, and the pain afterrespiratory effort (postoperative spirometry)were assessed at 12 and 24 hafter study drug administration.Results: Twelve-hour the number of button pressed and Fentanyldosage in Groups PRE were less than that of T and POST(P＜0.05). Painscores after spirometry were lower in Groups PRE than in T (P＜0.05).Twelve-hour FVC preserved in Group PRE was the best (P＜0.05).Therewere no inter-group differences in adverse effects or perioperative bloodloss.Conclusions: Perioperative intravenous administration ofFlurbiprofen provided a Fentanyl-sparing effects, as well asimprovements in pain control and 12-h FVC in paitients recovering fromabdominal hysterectomy surgery.