Lack of preemptive analgesia by intravenous flurbiprofen in thyroid gland surgery: a randomized, double-blind and placebo-controlled clinical trial

Abstract

Background: Nowadays, increasingly more preemptive analgesia studies focus on postoperative pain; however, the impact of preemptive analgesia on perioperative opioid requirement is not well defined. This study was carried out in order to evaluate whether preoperative intravenous flurbiprofen axetil can reduce perioperative opioid consumption and provide postoperative analgesia in patients undergoing thyroid gland surgery.

Methods: Ninety patients undergoing elective thyroid gland surgery were randomly assigned to three groups. Group A (Control) was administered Intralipid(®) 2 ml as a placebo 15 min before the cervical plexus block and at the end of the surgery; Group B (Routine analgesia) was administered a placebo 15 min before the cervical plexus block and flurbiprofen 50 mg at the end of the surgery; Group C (Preemptive analgesia) was administered intravenous flurbiprofen 50 mg 15 min before the cervical plexus block and a placebo at the end of the surgery. Sufentanil administration during the surgery and the 24 h satisfaction score on analgesic therapy were both recorded. The analgesic efficacy was assessed at 1, 2, 4, 6, 8, 12, and 24 hours after the surgery, based on visual analog scales.

Results: Ninety patients were involved in the study. One patient from Group B did not have their scheduled surgery; eighty-nine patients completed the study. There were no significant differences in the patient demographics between the three groups. Visual analog scales: 1, 2, 4 h for Group A was significantly higher than Groups B and C (P<0.05); Sufentanil administration during surgery: Group C was obviously lower compared to Groups A and B (P<0.05); 24 h satisfaction score: Groups B and C were higher than Group A (P<0.05).

Conclusion: Preoperative administration of intravenous Flurbiprofen axetil reduced analgesic consumption during surgery, but not postoperative pain scores.

Keywords: Flurbiprofen; cervial plexum block; postoperative pain.; preemptive analgesia; thyroid gland surgery.

Figure 1

Visual analog pain scale, patients rated their levels of pain on the 0-10 cmVAS (0 cm = no pain to 10 cm = the worst possible pain). ^* P<0.05 Preemptive analgesia and routine analgesia group versus the control group.

Figure 2

The ratios of people need additional postoperative analgesia. ^* P<0.05 Preemptive analgesia and routine analgesia group versus the control group.

Figure 3

Sufentanil consumption during surgery. ^* P<0.05, Preemptive analgesia group versus the control group;^†P<0.05 Preemptive analgesia group versus routine analgesia group.

Figure 4

24h satisfaction score, patients rated their levels of analgesic satisfaction on the 0-4score (0 very unsatisfied, 1 unsatisfied, 2 satisfied, 3 very satisfied). ^* P<0.05 Preemptive analgesia and routine analgesia group versus the control group.