Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

Yajun Xu, Zhiming Tan, Jiawei Chen, Feifei Lou, Wei Chen

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose: Flurbiprofen axetil (FA) is a potent non-steroidal anti-inflammatory drug (NSAID). We examined the effects that perioperative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. Methods: This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg·kg-1 iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. Results: The times to first bowel movement (87 ± 23 vs 105 ± 19 hr, P = 0.008) and first flatus (63 ± 16 vs 75 ± 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Conclusion: Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.

Original languageEnglish (US)
Pages (from-to)414-422
Number of pages9
JournalCanadian Journal of Anesthesia
Volume55
Issue number7
DOIs
StatePublished - Jan 1 2008

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Colorectal Surgery
Patient-Controlled Analgesia
Epidural Analgesia
Epidural Anesthesia
Cytokines
Leukocyte Count
flurbiprofen axetil
Anti-Inflammatory Agents
Thorax
Flatulence
Pain
Control Groups
Gastrointestinal Motility
Recovery of Function
Pain Measurement
Postoperative Pain
Interleukin-8
Intravenous Administration
Interleukin-10
Analgesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery. / Xu, Yajun; Tan, Zhiming; Chen, Jiawei; Lou, Feifei; Chen, Wei.

In: Canadian Journal of Anesthesia, Vol. 55, No. 7, 01.01.2008, p. 414-422.

Research output: Contribution to journalArticle

Xu, Yajun ; Tan, Zhiming ; Chen, Jiawei ; Lou, Feifei ; Chen, Wei. / Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery. In: Canadian Journal of Anesthesia. 2008 ; Vol. 55, No. 7. pp. 414-422.
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title = "Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery",
abstract = "Purpose: Flurbiprofen axetil (FA) is a potent non-steroidal anti-inflammatory drug (NSAID). We examined the effects that perioperative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. Methods: This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg·kg-1 iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. Results: The times to first bowel movement (87 ± 23 vs 105 ± 19 hr, P = 0.008) and first flatus (63 ± 16 vs 75 ± 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Conclusion: Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.",
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T1 - Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery

AU - Xu, Yajun

AU - Tan, Zhiming

AU - Chen, Jiawei

AU - Lou, Feifei

AU - Chen, Wei

PY - 2008/1/1

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N2 - Purpose: Flurbiprofen axetil (FA) is a potent non-steroidal anti-inflammatory drug (NSAID). We examined the effects that perioperative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. Methods: This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg·kg-1 iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. Results: The times to first bowel movement (87 ± 23 vs 105 ± 19 hr, P = 0.008) and first flatus (63 ± 16 vs 75 ± 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Conclusion: Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.

AB - Purpose: Flurbiprofen axetil (FA) is a potent non-steroidal anti-inflammatory drug (NSAID). We examined the effects that perioperative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. Methods: This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg·kg-1 iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. Results: The times to first bowel movement (87 ± 23 vs 105 ± 19 hr, P = 0.008) and first flatus (63 ± 16 vs 75 ± 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Conclusion: Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.

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