title: Flurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in β-endorphin levels.
abstract: OBJECTIVE
  To examine the analgesic effect of preoperative administration of flurbiprofen axetil and that of postoperative administration of a combination of flurbiprofen axetil and fentanyl, as well as perioperative plasma β-endorphin (β-EP) levels in patients undergoing esophagectomy.
  
  
  METHODS
  Forty-five patients were randomly divided into three groups: group A: 100 mg flurbiprofen axetil preoperative, 10 μg/kg fentanyl + 10 ml placebo postoperative; group B: 100 mg flurbiprofen axetil preoperative, 10 μg/kg fentanyl + 100 mg flurbiprofen axetil postoperative; group C: 10 ml placebo preoperative, 10 μg/kg fentanyl + 10 ml placebo postoperative. Postoperative analgesia was achieved by intravenous infusion containing flurbiprofen axetil and/or fentanyl at 2.0 ml/h (total volume, 100 ml) using infusion pumps. The β-EP was measured at preanesthesia (T(1)), the end of surgery (T(2)), 24 h (T(3)), and 48 h (T(4)) after surgery. Visual analog scale scores (VAS) at T3, T4 (at rest), and rescue analgesic tramadol requirement was recorded.
  
  
  RESULTS
  The VAS of group B was significantly lower than group A and C (P < 0.01) at T(3) and T(4). The β-EP levels at T(2)-T(4) in group A did not differ significantly from those at T(1) (P > 0.05); however, the β-EP levels in group B at T(3)-T(4) increased significantly (P < 0.05), while those in group C increased at T(2) and decreased at T(4) (P < 0.05). The β-EP levels in group B at T(3) and T(4) were the highest as compared to its levels in groups A and C (P < 0.01). Tramadol consumption in group B was significantly lower than in groups A and C (P < 0.01).
  
  
  CONCLUSIONS
  These results show that flurbiprofen axetil enhances the analgesic effect of fentanyl associated with increase in β-EP levels.
authors: Department of Anesthesiology, Yijishan Hospital of Wannan Medical College, Wuhu, 241001, China.
authors: Zhao-Fang
authors: ZF
authors: Liu
authors: Xiao-Qing
authors: XQ
authors: Chai
authors: Kun-Zhou
authors: KZ
authors: Chen
mesh_terms: D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000097:blood / Q000601:surgery; D016629:Esophagectomy / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005480:Flurbiprofen / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010919:Placebos; D011300:Preoperative Care / Q000379:methods; D001615:beta-Endorphin / Q000097:blood*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D005480:Flurbiprofen; D001615:beta-Endorphin; C504422:flurbiprofen axetil; D005283:Fentanyl