Effect of flurbiprofen axetil for postoperative analgesia on blood coagulation: a meta-analysis

Abstract

Objective To analyze the effect of flurbiprofen axetil (FA) on blood coagulation in patients undergoing surgery through systematic review and meta-analysis. Methods PubMed, WanFang and CNKI databases were searched from their establishment to August 2017 by computer retrieval for relevant literature on the blood coagulation effect of FA. The references of the studies included were also searched by hand. Two reviewers independently screened the literature, extracted data from full-text articles, and evaluated the methodological quality of included studies. All data were analyzed by Review Manager 5.3. Results Altogether 11 studies were finally included, consisting of 10 RCTs and one case-control study, involving 643 patients undergoing surgery. The mean Jadad score for all the studies included were less than 3, suggesting low methodological quality of the studies included. The pool analysis of 4 blood coagulation indexes (prothrombin time, thrombin time, activated partial thromboplastin time and fibrinogen) and platelet count showed that there were no significant differences between the control group and flurbiprofen axetil group before treatment and at 30 min, 1-2 h, 6-8 h, 12 h, 24 h and 48 h after treatment (P>0.05) . As for other outcomes like Sonoelot coagulation indexes [activated clotting time of whole blood, coagulation rate and platelet function (PF)], time to peak, mean platelet volume, maximum platelet aggregation rate, platelet aggregation rate at 1 min (PAG1), platelet aggregation rate at 5 min (PAG5) and platelet aggregation rate maximum, no significant differences were found except in one study where PF was found to be lower at 2 h after treatment in the FA group than in the control group. Conclusion Use of FA in common clinical doses is safe for postoperative analgesia, because blood coagulation may not be significantly affected. Key words: Systematic review; Analgesia; Posoperative period; Flurbiprofen axetil; Blood coagulation