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Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

Masayasu Nakayama, MD^*, Hiromichi Ichinose, MD^*, Shuji Yamamoto, MD^*, Ken-ichi Nakabayashi, MD^*, Osamu Satoh, MD^* and Akiyoshi Namiki, MD PhD

^* From the Division of Anesthesia,
Obihiro Kosei Hospital, Obihiro, and Sapporo Medical University School of Medicine, Sapporo, Japan.

Address correspondence to: Dr. M. Nakayama, Division of Anesthesia, Obihiro Kosei Hospital, West-6, South-8-1, Obihiro 080-0016, Japan. Phone: +0155/24-4161; Fax: +0155/25-7851; E-mail: miyabi{at}zc4.so-net.ne.jp

Purpose: To assess whether perioperative intravenous administration of flurbiprofen, a non-steroidal anti-inflammatory drug, reduced postoperative pain after abdominal hysterectomy.

Methods: Forty-five patients undergoing abdominal hysterectomy were randomly assigned to one of three groups of equal size. A control group (CONT) received a placebo 30 min before and at the end of surgery. The other two groups, PRE and POST, received 1 mg•kg^–1 flurbiprofen iv 30 min before and at the end of surgery, respectively. All patients received identical general and epidural anesthesia. Postoperatively, 50 mg diclofenac pr was given for pain relief on patient demand. One of the authors assessed pain using a 10 cm visual analog scale at rest and during coughing at the first request for diclofenac, and at 15, 24, 48, and 72 hr after surgery. The number of times diclofenac was required during the first 24 hr after surgery was also recorded.

Results: The number of diclofenac requests in the PRE (1.8 ± 0.4) and POST groups (2.0 ± 0.4) were less than in the CONT group (3.0 ± 0.4). The PRE group showed lower visual analog scale at rest at 15 and 24 hr and on coughing at 24, 48, and 72 hr after surgery than the CONT and POST groups.

Conclusion: Intravenous 1 mg•kg^–1 flurbiprofen administered during anesthesia reduces postoperative rescue analgesic requirement after abdominal hysterectomy. Moreover, flurbiprofen is more effective when given before than after surgery.

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