[Comparison of analgesic effects of intravenous flurbprofen and suppository indomethacin after laparoscopic cholecystectomy].
BACKGROUND
Epidural analgesia may not be necessary after laparoscopic cholecystectomy, but analgesics, such as non-steroidal anti-inflammatory drugs, may often be required postoperatively. There have been only a few studies comparing different NSAIDs in this situation.


METHODS
After laparoscopic cholecystectomy under general anesthesia using intravenous propofol, nitrous oxide and fentanyl 3 micrograms.kg-1, 40 patients were randomly allocated to receive either intravenous flurbprofen 50 mg or suppository indomethacin 50 mg. Visual analogue scales of postoperative pain at 0, 10, 20, 30 and 60 min after surgery (at rest and at coughing), use of rescue analgesics, and the presence or absence of complications were recorded.


RESULTS
Pain score at rest was markedly reduced (> 15% reduction from the baseline value) in 13 of 20 patients after injection of flurbiprofen and in five patients after indomethacin during the initial 60 min after surgery (P < 0.05), whereas there was no significant difference between the two groups for the pain score during coughing. There was no difference in the need of rescue analgesics within the initial 60 min, but the flurbiprofen group required significantly more rescue analgesics than the indomethacin group during 1-24 h after surgery (P < 0.005). The incidence of complications was low in both groups.


CONCLUSIONS
Compared with suppository indomethacin, intravenous flurbiprofen is more effective in acute postoperative pain but the duration of its analgesic effect is shorter.
Yamazaki
Etsuko
E
Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8507.
Murao
Kohei
K
Asai
Takashi
T
Matsumoto
Sanae
S
Shingu
Koh
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005480:Flurbiprofen / Q000008:administration & dosage*; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D013488:Suppositories; D013997:Time Factors; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D005480:Flurbiprofen; D007213:Indomethacin