title: Effect of preoperative flupirtine on postoperative morphine sparing in patients undergoing total abdominal hysterectomy.
abstract: BACKGROUND
  Flupirtine is a unique non-opioid, centrally acting analgesic with muscle relaxant properties. So far no study has evaluated, use of preoperative flupirtine on postoperative morphine sparing effect in patients undergoing total abdominal hysterectomy (TAH).
  
  
  METHODS
  We performed a prospective, controlled, and randomized study in 50 female patients of American Society of Anesthesiologists physical status I-II, aged between 30 and 60 years scheduled for TAH under general anesthesia (GA). Patients were randomized to receive either single dose flupirtine 100 mg or placebo 1 h prior to surgery. A standard anesthetic and analgesic protocol was followed in both the groups. Postoperatively, a titrated loading dose of intravenous morphine 0.1 mg/kg was followed with patient-controlled analgesia with morphine (bolus of 0.01 mg/kg with a lockout time of 7 min). The primary outcome was cumulative morphine consumption at 48 h postoperatively. Secondary outcomes included hemodynamics, visual analog scale (VAS) at rest, VAS on cough, and any adverse effects.
  
  
  RESULTS
  All enrolled 50 patients completed the follow-up. The cumulative mean morphine consumption (standard deviation [SD]) at 48 h (40.4 [6.0] vs. 47 [6.6] mg, P = 0.001) was reduced in-group flupirtine as compared with placebo. The cumulative mean VAS at rest (SD) (3 [0.7] vs. 3.7 [0.7], P = 0.001) and on cough (3 [0.9] vs. 3.8 [0.5], P = 0.002) were reduced in-group flupirtine as compared with placebo at 48 h postoperatively.
  
  
  CONCLUSIONS
  Preoperative use of flupirtine exhibited morphine sparing effect in patients following TAH under GA at 48 h.
authors.affiliation: Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Thapa
authors.affiliation: Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors.forename: V
authors.initials: V
authors.lastname: Ahuja
authors.affiliation: Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors.forename: C
authors.initials: C
authors.lastname: Dass
authors.affiliation: Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Gombar
authors.affiliation: Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Huria
keywords: Abdominal hysterectomy; acute pain; analgesia