The analgesic effect and inflammatory mechanism of nonsteroidal analgesics combined with nerve block in post-gynecologic surgery patients

Abstract

Objective: To investigate the analgesic effect and inflammatory mechanism of nonsteroidal analgesics combined with nerve block in post-gynecologic surgery patients.

Methods: Sixty patients who underwent gynecological laparotomies in our hospital were enrolled in this retrospective cohort study, with 30 patients administered nonsteroidal analgesics combined with nerve block (the observation group) and 30 patients administered nonsteroidal analgesics alone (the control group). The patients in the observation group were administered an intravenous injection of flurbiprofen axetil 1 mg/kg before the end of the operation, and 0.375% ropivacaine was used for bilateral transversus abdominis plane block after the operation. The patients in the control group were administered only an intravenous injection of flurbiprofen axetil 1 mg/kg before the end of the operation. The blood pressure (BP), heart rate (HR), visual analogue scale (VAS) scores, and the numerical rating scale (NRS) scores were recorded before the operation (T0) and at 1 h (T1), 6 h (T2), 12 h (T3), and 24 h (T4) after the recovery from the anesthesia. The incidences of emergence agitation, and the operation and recovery times in the two groups were recorded. Blood samples were collected before and at one day after the operations to measure the inflammatory factor levels such as IL-6, IL-1β, and TNF-α.

Results: The BP, HR, and the VAS and NRS scores in the observation group at T1, T2, T3, and T4 were lower than they were in the control group (P<0.01). The inflammatory factor levels after the operation in the observation group were lower than they were in the control group (P<0.01). There was no significant difference in the incidences of complications between the two groups (P>0.05).

Conclusion: Flurbiprofen axetil combined with ropivacaine for bilateral transversus abdominis plane block has a significant analgesic effect on patients after gynecologic surgery. The mechanism may be due to the fact that nonsteroidal analgesics combined with nerve block further reduce the inflammatory factors in the body, which proves the superiority of multimodal analgesia.

Keywords: Flurbiprofen axetil; bilateral transversus abdominis plane block; multimodal combined analgesia.

Figure 1

Flow chart of the study.

Figure 2

Comparison of the VAS scores between the two groups. Compared with the control group, *P<0.05, **P<0.01, ***P<0.001. VAS: visual analogue scale; T0: before the operation; T1: 1 h after the recovery from anesthesia; T2: 6 h after the recovery from anesthesia; T3: 12 h after the recovery from anesthesia; T4: 24 h after the recovery from anesthesia.

Figure 3

Comparison of the NRS scores between the two groups. Compared with the control group, *P<0.05, **P<0.01, ***P<0.001. NRS: numerical rating scale; T0: before the operation; T1: 1 h after the recovery from anesthesia; T2: 6 h after the recovery from anesthesia; T3: 12 h after the recovery from anesthesia; T4: 24 h after the recovery from anesthesia.