Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Mar 10;8(3):216-21.
doi: 10.7150/ijms.8.216.

Effects of flurbiprofen on CRP, TNF-α, IL-6, and postoperative pain of thoracotomy

Hidir Esme  1 , Recep Kesli, Burhan Apiliogullari, Ferdane Melike Duran, Banu Yoldas
Affiliations
Randomized Controlled Trial

Effects of flurbiprofen on CRP, TNF-α, IL-6, and postoperative pain of thoracotomy

Hidir Esme et al. Int J Med Sci. .

Abstract

Objective: The aims of this study were to evaluate serum levels of acute phase reactants, such as CRP and cytokines (TNF-α and IL-6) in patients who have undergone thoracotomy and to investigate the effects of flurbiprofen on postoperative inflammatory response.

Methods: Forty patients undergoing posterolateral thoracotomy were randomly divided into 2 groups of 20 each. Control group received tramadol (4 x 100 mg) intravenously for four days, and flurbiprofen group received both tramadol (4 x 100 mg) and flurbiprofen (2 x 100 mg). Blood samples were collected before surgery and at the 3th and 168th hours after surgical procedure to measure serum CRP, IL-6, and TNF-α. Pain visual analog scales were recorded daily during the first four postoperative days. Spirometric measurement of forced expiratory volume in the first second (FEV 1) was done before and four days after the operation.

Results: The serum CRP, IL-6, and TNF-α levels in both groups increased significantly at 3th hour after thoracotomy. Serum TNF-α levels did not differ significantly between the groups at postoperative 4th day. However, IL-6 and CRP were significantly lower in flurbiprofen group than in control group at the same day (p < 0.05). Visual analog scale was significantly lower in flurbiprofen group at 6th, 12th, 48th, 72th, and 96th hours postoperatively (p < 0.05). The patients receiving flurbiprofen had higher FEV 1 values when compared with control group at postoperative 4th day.

Conclusions: Patients undergoing thoracotomy showed reduced postoperative pain, mean additional analgesic consumption, and serum IL-6 and CRP levels, when flurbiprofen was added to systemic analgesic therapy. Analgesia with anti-inflammatory drug may contribute to the attenuation of the postoperative inflammatory response and prevent postoperative pain in patients undergoing thoracotomy.

Keywords: Flurbiprofen; Inflammatory response; Thoracotomy pain.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
Postoperative pain scores as assessed by Visual Analogue Scale in the study groups.
Figure 2
Figure 2
Changes in serum concentration of TNF-α before and after thoracotomy in the study groups.
Figure 3
Figure 3
Changes in serum concentration of IL-6 before and after thoracotomy in the study groups.
Figure 4
Figure 4
Changes in serum concentration of CRP before and after thoracotomy in the study groups.
See this image and copyright information in PMC

References

    1. Andres BM, Taub DD, Gurkan I. et al. Postoperative fever after total knee arthroplasty: the role of cytokines. Clin Orthop Relat Res. 2003;415:221–31. - PubMed
    1. Yamada T, Hisanaga M, Nakajima Y. et al. Serum interleukin-6, interleukin-8, hepatocyte growth factor, and nitric oxide changes during thoracic surgery. World J Surg. 1998;22:783–90. - PubMed
    1. Katsuta T, Saito T, Shigemitsu Y. et al. Relation between tumor necrosis factor alpha and interleukin 1 beta producing capacity of peripheral monocytes and pulmonary complications following oesophagectomy. Br J Surg. 1998;85:548–53. - PubMed
    1. Takeda S, Takeda S, Kim C. et al. Preoperative administration of methylprednisolone attenuates cytokine-induced respiratory failure after esophageal resection. J Nippon Med Sch. 2003;70:16–20. - PubMed
    1. Hall GM, Peerbhoy D, Shenkin A. et al. Relationship of the functional recovery after hip arthroplasty to the neuroendocrine and inflammatory responses. Br J Anaesth. 2001;87:537–42. - PubMed

Publication types

MeSH terms