Flurbiprofen Axetil

The hyperactivity of the sympathetic nervous system after a traumatic event contributes to the development of post-traumatic stress disorder (PTSD). Polarised light stellate ganglion irradiation (PLSGI) is a non-invasive and effective physiotherapy method for regulating the sympathetic nervous system. This study aims to investigate the effects of perioperative PLSGI on PTSD and pain-related outcomes in patients undergoing emergency surgery.

This multicentre, randomised, double-blind, controlled trial will include 510 adult patients scheduled for emergency trauma surgery. Patients will be randomly assigned in a 1:1 ratio, stratified by anaesthesia type (propofol general anaesthesia or other anaesthesia), to either the PLSGI group or the control group. The PLSGI group will receive perioperative PLSGI, while the control group will receive a sham PLSGI procedure. All patients will receive multimodal analgesia, consisting of intraoperative flurbiprofen axetil, ropivacaine infiltration at the end of surgery and postoperative patient-controlled sufentanil. The primary outcome is the incidence of PTSD 1 month postoperatively. Secondary outcomes include the severity of PTSD, delayed-onset PTSD, four symptom clusters (intrusive re-experiencing symptoms, avoidance symptoms, negative alterations in cognition or mood symptoms, and hyperarousal and reactivity symptoms), severity of dissociative symptoms, the amount of emergency postoperative analgesia, heart rate variability, sleep quality, anxiety, chronic pain, postoperative opioid use (sufentanil consumption) and need for rescue analgesia. Safety outcomes include hypotension, bradycardia, hypertension, tachycardia, interventions for haemodynamic events, malignant arrhythmias, hoarseness, localised allergy or burning pain, dyspnoea and coughing while drinking. All analyses will be conducted in the modified intention-to-treat population.

Ethical approval was obtained from the Ethics Committee of Xuzhou Central Hospital (XZXY-LK-20210129-2023040), the Ethics Committee of Suzhou Xiangcheng People’s Hospital (2023-KY-02) and the Ethics Committee of Xuzhou Renci Hospital (XZRCLL-KT-202302001). All patients will provide written informed consent. The results of this study will be published in a peer-reviewed journal.

ChiCTR2300070852.

The analgesic effects between fentanyl, sufentanil, and butorphanol combined with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia (PCIA) after cesarean delivery has never been evaluated.

To evaluate the postoperative analgesic efficacy of selected PCIA formulae.

This is a retrospective study.

Department of Anesthesiology, Shenzhen Second People's Hospital, a medical center in Shenzhen City, Guangdong Province, People's Republic of China.

From January 2022 through October 2023, the records of 463 patients who underwent a cesarean delivery were reviewed at Shenzhen Second People's hospital. All used a postoperative PCIA formula combined with flurbiprofen axetil and an antiemetic (ondansetron or tropisetron). The patients were placed into one of 3 groups: the Fentanyl Group (fentanyl plus flurbiprofen axetil plus ondansetron or tropisetron, 178 patients); the Sufentanil Group (sufentanil plus flurbiprofen axetil plus ondansetron or tropisetron, 159 patients); or the Butorphanol Group (butorphanol plus flurbiprofen axetil plus ondansetron or tropisetron, 126 patients). The primary data collected were the perioperative use of analgesics, postoperative Visual Analog Scale score, and no differences in adverse reactions were observed, except for the incidence of nausea and vomiting.

A significant difference was found between using epidural analgesics (such as morphine) and intravenous analgesics (such as butorphanol, flurbiprofen axetil, tramadol, parecoxib, and dexmedetomidine). There was no difference among the groups in postoperative Visual Analog Scale scores at 24 hours and 48 hours post cesarean delivery. There also was no difference in adverse reactions.

Our study was limited by a small sample size and did not differentiate the Visual Analog Scale scores between states of rest and movement.

The analgesic effect in patients who underwent cesarean delivery is similar when using different postoperative PCIA formulae. Although butorphanol displayed no analgesic advantage over fentanyl and sufentanil postoperatively, it caused fewer postoperative nausea and vomiting incidences than fentanyl and sufentanil.