title: Intravenous flurbiprofen axetil enhances analgesic effect of opioids in patients with refractory cancer pain by increasing plasma β-endorphin.
abstract: BACKGROUND
  The study aimed to investigate the analgesic effect of a combination of intravenous flurbiprofen axetil and opioids, and evaluate the relationship between refractory pain relief and plasma β-endorphin levels in cancer patients.
  
  
  METHODS
  A total of 120 cancer patients was randomly divided into two groups, 60 patients took orally morphine sulfate sustained-release tablets in group A, and another 60 patients receiving the combination treatment of intravenous flurbiprofen axetil and opioid drugs in group B. After 7 days, pain relief, quality of life improvement and side effects were evaluated. Furthermore, plasma β-endorphin levels were measured by radioimmunoassay.
  
  
  RESULTS
  With the combination treatment of intravenous intravenous flurbiprofen axetil and opioids, the total effective rate of pain relief rose to 91.4%, as compared to 82.1% when morphine sulfate sustained-release tablet was used alone. Compared with that of group A, the analgesic effect increased in group B (p=0.031). Moreover, satisfactory pain relief was associated with a significant increase in plasma β-endorphin levels. After the treatment, plasma β-endorphin level in group B was 62.4±13.5 pg/ml, which was higher than that in group A (45.8±11.2 pg/ml) (p<0.05).
  
  
  CONCLUSIONS
  Our results suggest the combination of intravenous flurbiprofen axetil and opioids can enhance the analgesic effect of opioid drugs by increasing plasma β-endorphin levels, which would offer a selected and reliable strategy for refractory cancer pain treatment.
authors.affiliation: Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army, Wuhan, China E-mail : bichengzhang@hotmail.com.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Wu
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Wang
authors.forename: Wu-Ling
authors.initials: WL
authors.lastname: Ou
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Yao
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.forename: Zhi-Guo
authors.initials: ZG
authors.lastname: Rao
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Gao
authors.forename: Bi-Cheng
authors.initials: BC
authors.lastname: Zhang
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005480:Flurbiprofen / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D011379:Prognosis; D011788:Quality of Life; D011863:Radioimmunoassay; D001615:beta-Endorphin / Q000097:blood*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005480:Flurbiprofen; D001615:beta-Endorphin; C504422:flurbiprofen axetil