title: Effects of flurbiprofen on CRP, TNF-α, IL-6, and postoperative pain of thoracotomy.
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.
authors: Department of Thoracic Surgery, Konya Education and Research Hospital, Konya, Turkey.
authors: Hidir
authors: H
authors: Esme
authors: Recep
authors: R
authors: Kesli
authors: Burhan
authors: B
authors: Apiliogullari
authors: Ferdane Melike
authors: FM
authors: Duran
authors: Banu
authors: B
authors: Yoldas
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005480:Flurbiprofen / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood*; D007902:Length of Stay / Q000706:statistics & numerical data; D008168:Lung / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D013908:Thoracotomy / Q000009:adverse effects*; D014147:Tramadol / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D000700:Analgesics; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D014147:Tramadol; D005480:Flurbiprofen; D002097:C-Reactive Protein