<p>Intraoperative administration of intravenous flurbiprofen axetil with nalbuphine reduces postoperative pain after orbital decompression: a single-center, prospective randomized controlled trial</p>

Abstract

Purpose This study aimed to investigate postoperative analgesia achieved with intraoperative administration of intravenous flurbiprofen axetil and nalbuphine in patients undergoing orbital decompression. Methods Sixty-three patients undergoing orbital decompression under general anesthesia at the Zhongshan Ophthalmic Center at Sun Yat-sen University (Guangzhou, China) were randomly allocated into one of the following three groups (1:1:1): intraoperative flurbiprofen axetil 100 mg (Group 1); intraoperative nalbuphine 0.1 mg/kg (Group 2); or intraoperative flurbiprofen axetil 100 mg combined with nalbuphine 0.1 mg/kg (Group 3). The primary end point was mean postoperative pain intensity during the first 24 hours. The secondary efficacy end points were the intensity of pain and discomfort at 0, 2, 6, 10, and 24 hours after surgery and side effects at 24 hours after surgery. Results The demographic characteristics were similar among the three groups. Mean and peak postoperative pain scores during the first 24 hours in Group 3 were lower than those in Group 1 ( P =0.007 and P =0.003, respectively) and Group 2 ( P =0.001 and P =0.000, respectively). Additionally, the pain scores in Group 3 were significantly lower than those in Group 1 during the first 6 hours after surgery ( P =0.003, 0.002, and 0.022 at 0, 2, and 6 hours, respectively) and those in Group 2 during the first 10 hours after surgery ( P =0.008, 0.000, 0.001, and 0.019 at 0, 2, 6, and 10 hours, respectively). Discomfort scores were not significantly different among the three groups during the observation period, except at 2 hours after surgery, at which time the scores in Group 3 were significantly lower than those in Group 2 ( P =0.033). Postoperative adverse effects and analgesic requirements were similar among the three groups. Conclusion Intraoperative administration of a combination of intravenous flurbiprofen axetil and nalbuphine is superior to single-dose flurbiprofen axetil or nalbuphine in patients undergoing orbital decompression.

<p>Preemptive Nalbuphine Attenuates Remifentanil-Induced Postoperative Hyperalgesia After Laparoscopic Cholecystectomy: A Prospective Randomized Double-Blind Clinical Trial</p>

“…The analgesic and antihyperalgesic actions of NSAIDs are attributed to inhibition of peripheral prostaglandin synthesis in inflamed tissues, as well as COX inhibition in the central nervous system. 10,21,22 Postoperative hyperalgesia usually leads to higher pain scores and earlier need for rescue analgesics. 23 We found that the NRS scores and postoperative analgesic need were highest in the high-dose remifentanil arm compared to the other groups.…”

Administration of flurbiprofen axetil and dezocine for the postoperative analgesia in patients with non‑small cell lung cancer: A randomized, controlled study

“…For example, flurbiprofen axetil plus dexmedetomidine reduces the VAS score and Bruggrmann comfort scale at 6 and 12 h following surgery compared with flurbiprofen axetil monotherapy in patients with resectable lung cancer (13). Moreover, an additional study indicated that flurbiprofen axetil plus nalbuphine decreases the pain score compared with nalbuphine monotherapy at 2, 6, and 10 h following orbital decompression (23). Furthermore, dezocine is another commonly prescribed analgesic agent in China, which has indicated effective analgesic effects in patients with liver cancer who underwent hepatectomy and in patients with postoperative breast cancer (15,16).…”

Retrospective analysis of risk factors of postoperative nausea and vomiting in patients undergoing ambulatory strabismus surgery via general anaesthesia

“…Nalbuphine is indicated by the Food and Drug Administration (FDA) for moderate to severe pain;[ 23 ] our previous study found that nalbuphine is an optimal analgesic to control postoperative pain after ophthalmic surgery. [ 24 ] In the current study, we used either nalbuphine or NSAIDs to prevent the postoperative pain, and none of the patients declared severe pain or received an additional dose of analgesics during the phases I and II recovery periods. However, as a kappa-opioid receptor agonist and a partial mu-opioid receptor antagonist, nalbuphine has been reported to induce the same incidence of PONV as morphine.…”