Effect of flurbiprofen axetil on postoperative delirium for elderly patients

Abstract

Objectives Proinflammatory cytokines triggered by surgery and postoperative pain are major causes of postoperative delirium (POD). This study investigated the effects of flurbiprofen axetil on POD when used for postoperative analgesia after major noncardiac surgery in elderly patients. Methods Patients over 65 years old were randomly divided into two groups: the sufentanil group (S group), in which 150 μg of sufentanil was used in the patient‐controlled analgesia (PCA) pump for 3 days; the sufentanil combined with flurbiprofen axetil group (SF group), in which 150 μg of sufentanil was combined with 300 mg of flurbiprofen axetil in the PCA pump for 3 days. The Confusion Assessment Method scale was used for POD evaluation. The pain intensity, side effects, and risk factors (age, gender, surgical position, and category of surgery) for POD were evaluated. Results Ultimately, 140 patients were included. The overall incidence of POD was not significantly different between the S and SF groups. The incidence of POD was significantly lower in the SF group than in the S group among patients over 70 years (5.1% vs. 20.7%, p = 0.045, odds ratio = 0.146, 95% confidence interval = 0.020–1.041). The incidence of POD was no difference in patients classified by the category of surgery, surgical position, or gender between groups. Sufentanil and flurbiprofen axetil in the PCA pump was completely used within 72 hr. The pain intensity, consumed sufentanil dosage of the PCA, and the side effects was not different between groups. Conclusions Flurbiprofen axetil might reduce POD in patients over 70 years undergoing major noncardiac surgery.

White-Cell Derived Inflammatory Biomarkers in Prediction of Postoperative Delirium in Elderly Patients Undergoing Surgery for Lower Limb Fracture Under Non-General Anaesthesia

“… 35 , 36 Several clinical trials revealed NSAIDs may help decrease the incidence of delirium. 37 , 38 However, our study did not confirm this association. Inconsistent standards of dosage and duration of administration may be important reasons.…”

Effect of flurbiprofen axetil combined with “Cocktail” therapy on opioid dosage in patients after total knee arthroplasty

“…To explain it, flurbiprofen axetil does not produce central side effects similar to morphine respiratory depression. It was confirmed by Wang X et al 23 that flurbiprofen axetil can not only reduce inflammatory reaction and induce neuroprotective effect, but also overcome the adverse effects of other COX inhibitors and reduce the occurrence of gastric mucosal adverse reactions. 24 In addition, both flurbiprofen axil and “cocktail” therapy have been proved to have neither significant effect on the motor nerve of patients nor adverse effect on postoperative recovery of knee function in patients with TKA.…”

Pharmacological strategies to prevent postoperative delirium: a systematic review and network meta-analysis

“…Of these, 182 studies were discarded after reviewing the title and abstracts for the following reasons: related to other topics, designed as systematic reviews, reviews or retrospective studies, and conference abstracts. The full texts of the 63 remaining studies were reviewed in detail; 12 studies were excluded for the following reasons: three were study protocols [ 25 – 27 ], two were editorials [ 13 , 28 ], four were systematic reviews, [ 9 – 12 ] and three did not report the outcome of our interest (two compared an inhalational agent [ 13 , 29 ] and one was compared in the PCA regimen [ 30 ]). Thus, 51 studies with a total of 22,565 patients that included 18 different pharmacological interventions were included in this NMA ( Fig.…”