Flurbiprofen Group Research Articles

A novel temperature‐controlled device with standardized manipulation improves chronic back pain mediated by modulating deep muscle thickness: A multicenter randomized controlled trial

AbstractBackgroundChronic back pain affected 619 million people globally in 2020 which accounts for a heavy disease burden causing tremendous productivity losses. Current therapies including ibuprofen, duloxetine, and opioids might cause side effects and even severe drug use disorders. Therefore, a non‐pharmacologic therapy with better or equivalent efficacy and fewer side effects is needed.MethodsWe did a multi‐center, single‐blinded, randomized, positive drug controlled, clinical trial. Patients with chronic back pain in moderate severity were randomized into receiving hot stone massage or flurbiprofen plaster group. Both interventions were 2 weeks with a follow‐up of 4 weeks. The primary outcome was the change in the score of the Global Pain Scale (GPS) from baseline to week 2. Secondary outcomes included Numerical Rating Scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), Pain Self‐Efficacy Questionnaire (PSEQ), Hospital Anxiety and Depression Scale (HADS), and Short Form‐36 (SF36) from baseline to week 2 and week 6. Exploratory outcome assessment included the muscle thickness measured by ultrasound. Any adverse event was monitored throughout the study period.ResultsA total of 120 patients were enrolled in this trial. At 2 weeks GPS decreased significantly in the hot stone massage group compared to the flurbiprofen group (difference between groups = ‐8.1 points, 95% confidence interval [CI] ‐15.8 to ‐0.3, p = 0.047). Moreover, hot stone massage also showed more improvement at 2 weeks compared to flurbiprofen, including NRS (‐0.5 points, 95% CI ‐1.0 to ‐0.1, p = 0.029), PSEQ (5.4 points, 95% CI 0.5 to 10.2, p = 0.030), and mental component of Short Form‐36 (SF‐36) (1.7 points, 95% CI 0.4 to 2.9, p = 0.010), but not in CPAQ (p = 0.131), HADS (p = 0.303 for depression, p = 0.399 for anxiety), or SF‐36 (p = 0.129 for physical component, p = 0.246 for social component, p = 0.076 for fatigue component). A total of two participants in the hot stone massage group reported mild pain on skin surface when receiving the procedure at the first intervention session.

Association between perioperative flurbiprofen administration and acute kidney injury (AKI) in spine surgery: a retrospective cohort study

BackgroundThe association between nonsteroidal anti-inflammatory drugs (NSAIDs) and postoperative acute kidney injury (AKI) remains controversial, with limited studies specifically examining flurbiprofen. Therefore, this research aimed to investigate the association between intraoperative flurbiprofen administration and postoperative AKI.MethodsWe retrospectively identified a cohort of patients at the Third Xiangya Hospital of Central South University. A total of 3882 adult patients undergoing spinal surgery between January 1, 2012, and July 31, 2018, were included and classified into two groups: those receiving flurbiprofen (50 or 100 mg once, 5 min after anesthesia start) and those not receiving flurbiprofen. The primary endpoint was the incidence of AKI.ResultThe flurbiprofen group (4.4%) had a lower incidence of AKI compared to the non-flurbiprofen group (6.5%, P < 0.001). After adjusting for potential confounding variables, the multivariable regression analysis showed that the flurbiprofen group had a 49% reduced risk of postoperative AKI (OR 0.51; 95% CI 0.31 to 0.82) compared to the non-flurbiprofen group. Subgroup analysis indicated that flurbiprofen injection was associated with a reduced incidence of postoperative AKI in patients without diabetes (OR 0.61; 95% CI 0.19 to 0.74), surgical times of 2–5 h (OR 0.54; 95% CI 0.23 to 0.75), and preoperative anemia (OR 0.57; 95% CI 0.21 to 0.74).ConclusionThe study concluded that perioperative flurbiprofen treatment was associated with a lower risk of postoperative AKI in adult patients undergoing spinal surgery.

Assessment of anxiolytic-like effects of acute and chronic treatment of flurbiprofen in murine

Background: Non-steroidal anti-inflammatory drugs are commonly used medications with atypical pharmacological effects. This aims to evaluate the anxiolytic-like effects of flurbiprofen in rodent models. Methods: In vivo experimental try was conducted from October 2022 to January 2023 at the college of veterinary medicine, university of Mosul, Iraq. The effect of flurbiprofen was assessed in mice exposed to the elevated plus maze (EPM), light-dark box test (LDT), and open-field test (OFT). Fifty male mice were divided into two groups of twenty-five, weighing 30–35 g, for acute and chronic treatment. Each group was subdivided into five subgroups: distilled water was administered to the control group; the positive control was injected with 10 mg/kg diazepam; and the flurbiprofen groups were administered orally at 10, 20, and 40 mg/kg. Each subgroup was subjected to EPM, LDT, and OFT one hour after administration. The second group was also subdivided like the first group. It was treated for 15 days constantly and subjected to anxiety tests on the 16th day. Results: Acute treatment with 20 mg/kg flurbiprofen revealed an anxiolytic effect, with increased time spent in the open arm of the EPM test, increased time spent in the LDB test, and increased time spent in the central area in the OFT compared to the control group. Chronic administration of flurbiprofen was ineffective in producing an anxiolytic effect. Conclusion: The low doses of flurbiprofen may eliminate the anxiety effect in experimental mice; however, the anti-anxiety effect does not appear significantly after repeated or chronic administration of flurbiprofen.

The Effect of Flurbiprofen Lozenge on Pain, Oedema, and Trismus after Impacted Third Molar Surgery: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study

Background: The postoperative sequelae after third molar surgery include pain, swelling and trismus, Flurbiprofen is a non-steroidal anti-inflammatory drug (NSAID), and the anti-inflammatory mechanism of Flurbiprofen is thought to involve inhibition of prostaglandin biosynthesis, in common with other NSAIDs. Prostaglandins such as prostaglandin E2 (PGE2) and other inflammatory mediators released in response to pain or non-infectious stimulants trigger a complex inflammatory cascade that contributes to inflamation symptomsThis study was aimed to evaluate the efficacy of oral Flurbiprofen lozenge given 30 min before surgery on reducing postoperative sequelae. Method: We recruited 70 patients, randomly assigned to two groups: Flurbiprofen and Control group, groups received 100mg Flurbiprofen lozenge, placebo lozenge 30 min before surgery respectively and every 6h till 72h after surgery. Third molar extraction was performed under local anesthesia. After extraction, pain, swelling, and mouth opening in both groups observed till 72h. Statistical Analysis: Preoperative and postoperative measurement of visual analog scale scores for pain, edema, interincisal opening, was analyzed using Student t test or ANOVA, Chi-square or Mann-Whit-ney U test was performed for non-parametric samples. P &lt; 0.05 was considered as statistically significant. Results: The overall incidence of Pain in the Flurbiprofen group was 18% compared to 43% in the Control group (P = .003) Incidence of Pain, swelling, and mouth opening at different time intervals 6h, 24h, 48h and 72h were significantly (P &gt;0.05) better in Flurbiprofen group. Conclusion: Oral Flurbiprofen lozenge administered 30 minutes preoperatively can significantly reduce postoperative sequelae after third molar extraction.

Comparison Between Topical Nepafenac and Flurbiprofen in Maintaining Intraoperative Mydriasis and Controlling Postoperative Inflammation in Cataract Surgery

Background: Preoperative dilation of pupil is one of the prerequisistes to perform an uncomplicated cataract surgery. Intraoperative miosis is one of the many challenges which a surgeon can encounter during cataract surgery. Preoperative use of NSAIDS like nepefenac, flurbiprofen, ketorolac have been used for maintaining intra operative mydriasis and controlling postoperative inflammation by blocking prostaglandin synthesis. Aims: To compare the efficacy of nepafenac and flurbiprofen in maintaining intraoperative mydriasis and controlling postoperative inflammation Settings and Design: This was an institutional prospective comparative study done in rural Karnataka. Methods and Material: This study was performed on 110 patients, 55 were allocated in each group and were given either of the topical NSAID’s Nepafenac or Flurbiprofen prior to cataract surgery. Pupillary diameter was measured at the beginning and at the end of the surgery and the values were compared between the groups. Postoperative inflammation was also compared between both the groups. Statistical analysis used: The difference in flare and cells grading across groups were tested using Chi-Square test. p value of < 0.05 was considered statistically significant Results: The mean pupillary diameter of the two groups were comparable at the beginning of surgery The mean change in the pupillary diameter was more in flurbiprofen group when compared to nepafenac group. There was statistically significant difference among both the groups in maintenance of intraoperative mydriasis .The comparison of postoperative inflammation was also statistically different between both the groups. Conclusions: Pre-operative Nepafenac was found to be better than flurbiprofen in maintaining intraoperative mydriasis and controlling postoperative inflammation. Keywords: Cataract surgery, Surgical miosis, NSAIDs, Nepafenac, Flurbiprofen

COMPARISON OF THE EFFECT OF TOPICAL BROMFENAC AND TOPICAL FLURBIPROFEN IN MAINTAINING MYDRIASIS DURING CATARACT SURGERY

At the time of cataract surgery, one of the challenges a surgeon encounters is intraoperative miosis. This might increase the chances of intraoperative and postoperative complications. Thus, maintainence of adequate pupillary dilatation is necessary during cataract surgery. Aim of the study was to compare the effectiveness of prophylactic administration of topical bromfenac (0.09 % w/V) and topical flurbiprofen (0.03 % w/V) in maintaining mydriasis during the cataract surgery. A total of 100 patients were randomly divided into two groups of 50 each. Group 1 received topical bromfenac (0.09 %) and Group 2 received topical flurbiprofen (0.03 %). The mean percentage loss of mydriasis from the baseline was lesser in bromfenac group compared to flurbiprofen group (p &lt; 0.001). Topical bromfenac was found to be more effective in maintaining mydriasis during the cataract surgery when compared to the topical flurbiprofen.

Efficacy of Nepafenac versus Flurbiprofen in Maintaining Intraoperative Mydriasis During Phacoemulsification: A Comparative Study.

PurposeTo compare the efficacy of topical nepafenac (0.1%) with flurbiprofen (0.03%) in maintaining intra-operative mydriasis during phacoemulsification surgery.Patients and MethodsThis study comprised of 160 patients, who were divided into two arms of 80 each (arms A and B) after randomisation. Pre-operatively, all patients received one drop of tropicamide 0.8% and phenylephrine 5% (combination), 4 times, at an interval of 15 minutes on the day of surgery. Thereafter, Nepafenac drop in arm A/Flurbiprofen drop in arm B was administered 4 times, at an interval of 15 minutes keeping a gap of 10 minutes between tropicamide-phenylephrine and any of the experimental drugs. Phacoemulsification was performed one hour after the administration of last drop. Both vertical and horizontal pupillary diameter were measured at three steps; immediately before the surgical incision (baseline), at the end of emulsification of nucleus (before irrigation and aspiration) and at the end of surgery (after stromal hydration).ResultsThe difference in pupillary diameter between two groups, was statistically insignificant for vertical diameter (P = 0.08) and horizontal diameter (P = 0.28) at the start of surgery. On the other hand, pupillary diameter difference was statistically significant after emulsification of nucleus and at the end of surgery as well when both vertical (P < 0.05) and horizontal diameter (P < 0.05) were considered. The total reduction in pupillary diameter (both vertically and horizontally) was significantly less in the Nepafenac as compared to Flurbiprofen group (P < 0.05). Analysis of mean cumulative dissipated energy did not document any appreciable difference between the two groups. Phacoemulsification time analysis yielded statistically significant results (P = 0.004) between the Nepafenac and Flurbiprofen group.ConclusionIn the present study, topical Nepafenac (0.1%) proved to be more efficacious in maintaining intra-operative mydriasis during phacoemulsification surgery as compared to topical Flurbiprofen (0.03%).

Efficacy of the Delayed Use of Low-dose Aspirin in Intravenous Immunoglobulin Therapy for Acute-phase Kawasaki Disease

The mainstay of current standard therapy for acute-phase Kawasaki disease (KD) is intravenous immunoglobulin (IVIG) therapy at 2 g/kg. However, the efficacy of combining medium- or high-dose aspirin with IVIG therapy at 2 g/kg has not been fully investigated. Some studies suggested that aspirin may inhibit coronary artery lesion (CAL) prevention in IVIG therapy and that the delayed use of aspirin in IVIG therapy may be beneficial for the suppression of CALs and prevention of coronary artery stenosis in patients with KD. The efficacy of the delayed use of low-dose aspirin in IVIG therapy for acute-phase KD remains unclear. Therefore, this retrospective study aimed to assess the efficacy of the delayed use of low-dose aspirin, when combined with IVIG therapy for acute-phase KD. Data were obtained from 193 KD patients who underwent acute-phase treatment from January 2009 to October 2020 and IVIG therapy at 2 g/kg with the delayed use of aspirin/flurbiprofen. The patients were divided into three groups: (1) low-dose group, in which 40 patients received low-dose aspirin (5 mg/kg/day); (2) medium-dose group, in which 90 patients received medium-dose aspirin (30 mg/kg/day); and (3) flurbiprofen group, in which 63 patients received flurbiprofen (3–5 mg/kg/day). KD patients with liver damage or those present during influenza season underwent flurbiprofen therapy between January 2009 and November 2017. All patients except one received low-dose aspirin after December 2017. The serum albumin level (median 3.40 vs. 3.30 g/dL, P = 0.026) and Egami score (median 1.0 vs. 2.0, P &lt; 0.001) before the initial treatment were significantly different between the medium-dose group and the flurbiprofen group. The rates of initial IVIG therapy resistance (25.0% vs. 18.9% vs. 25.4%, P = 0.790), rescue therapy (17.5% vs. 8.9% vs. 17.5%, P = 0.721), and CALs (5.0% vs. 0.0% vs. 4.8%, P = 0.713) were similar among the low-dose, medium-dose, and flurbiprofen groups. Overall, the efficacy of the delayed use of low-dose aspirin was similar to that of the delayed use of medium-dose aspirin/flurbiprofen in IVIG therapy for acute-phase KD.

Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

BackgroundPostanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.MethodThis study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS.ResultsI retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015).ConclusionsMy result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

Oral Health-Related Quality of Life and the Use of Oral and Topical Nonsteroidal Anti-Inflammatory Drugs for Pericoronitis.

BackgroundPericoronitis is inflammation of the tissue surrounding a third molar, or wisdom tooth. This study aimed to evaluate the effects of oral and topical analgesic nonsteroidal anti-inflammatory drugs (NSAIDs) on oral health-related quality of life (OHQoL), in terms of oral health and lifestyle, in patients with symptomatic pericoronitis.Material/MethodsThe study included 60 patients who presented with pericoronitis and who did not undergo surgery within the following seven days. The patients were randomly assigned to three groups and were treated with oral diclofenac (N=20), oral flurbiprofen (N=20), and topical benzydamine (N=20). OHQoL was assessed for all study participants with a self-reported eight-item scale that was developed to evaluate pericoronitis. The total OHQoL scores were calculated for each day during the seven-day study period.ResultsThe study group treated with topical benzydamine had a significantly greater improvement in the OHQoL scores compared with the oral diclofenac and oral flurbiprofen groups on the first four days. Comparison of patients treated with diclofenac and flurbiprofen showed no significant differences for all seven days. A significant initial improvement in OHQoL was found on day 1 for the benzydamine group, on day 2 for the flurbiprofen group, and day 3 for the diclofenac group.ConclusionsIn this study, topical benzydamine was found to be a more effective alternative to oral NSAID analgesics, diclofenac and flurbiprofen, in improving OHQoL in patients with pericoronitis.

Effect of Flurbiprofen spray on postoperative tonsillectomy pain

Background and objectives: Tonsillectomy is one of the most frequently performed surgical procedures. Up to date there are no guidelines for pain control following tonsillectomy. The aim was to determine whether oral spray flurbipro- fen reduces pain and has an influence on wound healing following tonsillectomy. Methods: A Prospective, randomized study was done in Rizgary Teaching Hospital (Erbil-Iraq). This study was conducted on 60 patients who underwent ton- sillectomy between July 2017 and July 2018. Patients were randomly chosen and they were divided into two groups (thirty patients included in test group received flurbiprofen spray, other thirty included in control group). For test group oral spray flurbiprofen was used 3 times a day, every time three puffs. Postoperative pain was evaluated on the 1st, 4th, 7th and 10th postoperative days. The Efficacy was evaluated by universal pain assessment tool. Wound healing was evaluated on the 1st, 4th, 7th and 10th postoperative days. Results: The flurbiprofen group include 30 patients (18 males, 12 females) with a mean age of 23 years (range 12-40 years); the control group consisted of 30 patients (16 males, 14 females) with a mean age of 22 years (range12- 40 years). The severity of throat pain was lower in the flurbiprofen group when compared with the control group, and this difference was statistically highly significant for the 4th and the 7th day. Wound healing was not significantly different between the two groups. Conclusions: The use of flurbiprofen oral spray decreases postoperative tonsillectomy pain.

Intraoperative Flurbiprofen Treatment Alters Immune Checkpoint Expression in Patients Undergoing Elective Thoracoscopic Resection of Lung Cancer

Objectives: This study aimed to determine the effect of intraoperative administration of flurbiprofen on postoperative levels of programmed death 1 (PD-1) in patients undergoing thoracoscopic surgery. Materials and Methods: In this prospective double-blind trial, patients were randomized to receive intralipid (control group, n = 34, 0.1 mL/kg, i.v.) or flurbiprofen axetil (flurbiprofen group, n = 34, 50 mg, i.v.) before induction of anesthesia. PD-1 levels on T cell subsets, inflammation, and immune markers in peripheral blood were examined before the induction of anesthesia (T₀) and 24 h (T₁), 72 h (T₂), and 1 week (T₃) after surgery. A linear mixed model was used to determine whether the changes from baseline values (T₀) between groups were significantly different. Results: The increases in the percentage of PD-1⁽⁺⁾CD8⁽⁺⁾ T cells observed at T₁ and T₂ in the control group were higher than those in the flurbiprofen group (T₁: 12.91 ± 1.65 vs. 7.86 ± 5.71%, p = 0.031; T₂: 11.54 ± 1.54 vs. 8.75 ± 1.73%, p = 0.004), whereas no differences were observed in the changes in the percentage of PD-1⁽⁺⁾CD4⁽⁺⁾ T cells at T₁ and T₂ between the groups. Moreover, extensive changes in the percentage of lymphocyte subsets and inflammatory marker concentrations were observed at T₁ and T₂ after surgery and flurbiprofen attenuated most of these changes. Conclusions: Perioperative administration of flurbiprofen attenuated the postoperative increase in PD-1 levels on CD8⁽⁺⁾ T cells up to 72 h after surgery, but not after this duration. The clinical relevance of changes in PD-1 levels to long-term surgical outcome remains unknown.

A prospective evaluation of efficacy and safety of topical bromfenac 0.09% over topical flurbiprofen 0.03% after cataract surgery

Background: Different medications are used to reduce pain and inflammation after cataract surgery. Hence this study was taken up to compare the efficacy and safety of topical bromfenac 0.09% over topical flurbiprofen 0.03% in reducing anterior chamber inflammation and pain after cataract surgery.Methods: Total of 100 patients who underwent uneventful cataract surgery with posterior chamber intra ocular lens (IOL) implantation were randomly allocated to receive bromfenac 0.09% and flurbiprofen 0.03% topically from first post-operative day onwards for 6 weeks. Assessment of anterior chamber inflammation and pain was done by slit lamp and visual analogue scale respectively on each follow up days. Analysis was done by unpaired t test and Fischer’s exact test.Results: The response to treatment was earlier in bromfenac group for all the inflammatory changes (significant difference was found on day 7, p&lt;0.05) except for corneal edema where both the groups showed similar response. On 7th day after surgery, 72% patients in flurbiprofen group and 12% in bromfenac group had pain (score1), while on the 14th day none in the bromfenac group complained of pain whereas 4% in flurbiprofen group still had pain. Both the drugs were safe and no clinically serious adverse effects were observed in either of the groups.Conclusions: This study showed both the medications, topical bromfenac 0.09% and topical flurbiprofen 0.03% effective and safe in reducing pain and anterior chamber inflammation after cataract surgery but the response was earlier with bromfenac 0.09%.

Clinical efficacy and acceptability of 0.25% flurbiprofen mouthwash after periodontal flap surgery: A double-blinded, parallel-group, placebo-controlled, randomized clinical trial

Aim: The aim of the present study was to investigate the analgesic and anti-inflammatory efficacy of 0.25% flurbiprofen mouthwash, and to evaluate its effect on the parameters related to patient morbidity and early wound healing after periodontal flap surgery.Material and methods: Thirty-two patients (19 females and 13 males), diagnosed with moderate periodontitis and presenting at least one quadrant scheduled for periodontal flap surgery, were randomly allocated to either the flurbiprofen group or the placebo group. The plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) were evaluated at baseline and PI and GI were re-evaluated at 30-day follow-up. On postoperative 1, 3, 7, 14 and 30 days, postoperative pain, discomfort, changes in patientsÂ’ dietary habits, burning sensation and postoperative swelling were analyzed by using a visual analog scale (VAS). At postoperative 7 days, the early wound healing index was assessed clinically. Results: The mean VAS scores exhibiting postoperative pain were significantly lower in flurbiprofen group compared to placebo group at days 1, 7 and 30 (p

Oral flurbiprofen spray for postoperative sore throat and hoarseness: a prospective, randomized, double-blind, placebo-controlled study.

Sore throat and hoarseness are common complications after surgery. Flurbiprofen spray has been successfully used for treatment of oral inflammations, but its effects on postoperative sore throat and hoarseness are unknown. We conducted this study to evaluate the effectiveness of flurbiprofen spray on postoperative sore throat and hoarseness, by comparing it with benzydamine hydrochloride spray and placebo. One hundred fifty patients who were scheduled to undergo elective ear surgery were enrolled. Patients were randomized to three groups of 50 patients each; flurbiprofen oral spray, benzydamine hydrochloride oral spray and placebo spray groups. Patients received sprays just before intubation, and the incidence and severity of postoperative sore throat and hoarseness were evaluated by a blinded investigator at 0, 1, 6 and 24-hour post extubation. Patients were also questioned for possible side effects at all time points. The sore throat severity scores were significantly lower in treatment groups when compared to placebo group at all time points (P=0.003/108). Similarly, the incidence of sore throat was significantly lower in both of the treatment groups (P=0.007/104). The incidence of hoarseness and hoarseness scores were significantly lower in treatment groups when compared to placebo group (P=0.006/105 and P=0.005/104, respectively). While none of the patients complained of any adverse effects in flurbiprofen group, only two patients in benzydamine hydrochloride group experienced numbness. Both oral flurbiprofen and benzydamine hydrochloride sprays were found to be more effective than placebo in decreasing the incidence and severity of postoperative sore throat and hoarseness, with no adverse effects.

A comparative study on efficacy of nepafenac and flurbiprofen in maintenance of intraoperative mydriasis during cataract surgery: an open label randomized controlled trial

Background: Surgery on the ocular tissue brings about activation of phospholipase A3 thereby releasing prostaglandins and leukotrienes. Prostaglandins bring about meiosis during surgery, changes in IOP, conjunctival hyperaemia. Newer topical NSAID’s Nepafenac and Flurbiprofen are potent inhibitors of the cyclooxygenase enzyme thereby inhibiting the biosynthesis of prostaglandins. Objective of this study was to compare the efficacy of preoperative use of topical Nepafenac (0.1%) and Flurbiprofen (0.03%) in maintenance of intraoperative mydriasis during cataract surgery.Methods: A randomised, comparative study was performed on 104 patients, 52 were allocated in each group and were given either of the topical NSAID’s Nepafenac or Flurbiprofen prior to cataract surgery. Pupillary diameter was measured at the beginning and at the end of the surgery and the values were compared between the groups. Mean and standard deviation was calculated and between two groups comparison was done using students t-test.Results: The mean pupillary diameter of the two groups were comparable at the beginning of surgery (p=0.34). The mean change in the pupillary diameter was 1.86±0.71mm in the Nepafenac group and 1.77±0.72mm in the Flurbiprofen group. There was no statistically significant difference among both the groups in maintenance of intraoperative mydriasis (p=0.47).Conclusions: Pre-operative use of Nepafenac and Flurbiprofen were equally effective in preventing meiosis during cataract surgery.

Intravenous injection of low-dose flurbiprofen axetil for preventing post-ERCP pancreatitis in high-risk patients: An interim analysis of the trial

Background and study aims: Several meta-analyses and randomized control trials have demonstrated the efficacy of rectal nonsteroidal anti-inflammatory drugs for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Diclofenac or indomethacin was administered at a dose of 100 mg in those studies, which may be too high for Asian population. In addition, rectal administration can be considered complicated. Patients and methods: This study was a prospective, randomized, placebo-controlled trial. Patients with a PEP risk score ≥ 1 were randomly assigned to receive intravenous injection of 50 mg flurbiprofen axetil (flurbiprofen group) or saline only (placebo group). The primary outcome was reduced PEP. The secondary outcome was amylase level after 2 hours of ERCP as a predictor of PEP. (Clinical Trials.gov, ID UMIN000011322) Results: In total, 144 patients were enrolled from August 2013 to March 2015. We performed an interim analysis of the first 100 patients: 47 received flurbiprofen axetil and 53 received placebo. PEP occurred in 11 patients (11 %): 2 of 47 (4.3 %) in the flurbiprofen group and 9 of 53 (17 %) in the placebo group (P = 0.042). Relative risk reduction was 62.4 %. Hyperamylasemia did not differ significantly (17.0 % vs. 26.4 %, P = 0.109). This analysis resulted in early termination of the study for ethical reasons. Conclusions: Intravenous injection of low-dose flurbiprofen axetil after ERCP can reduce the incidence of PEP in high-risk patients

Oral Flurbiprofen Spray for Posttonsillectomy Pain.

Tonsillectomy is still one of the most common surgical procedures, but there exists no standard guideline for pain management after tonsillectomy. Our aim is to determine whether oral spray of flurbiprofen reduces pain and has an influence on other morbid outcomes following tonsillectomy. Prospective, double-blind, randomized, placebo controlled. Patients at Ataturk Training and Research Hospital, Ankara, Turkey. This study was performed on 84 patients (45 in flurbiprofen group, 39 in placebo group) who underwent tonsillectomy. The patients were randomly chosen, and each used oral spray of flurbiprofen 3 times daily or placebo solution at the same regimen. Efficacy was assessed by changes in Numeric Pain Rating Scale. Data were collected at postoperative days 1, 3, 5, and 7 for pain, bleeding, and healing. Data for Mallampati scores were also collected. There were no significant difference between groups with respect to the demographic data. The flurbiprofen group had statistically significant lower pain scores at days 1, 3, 5, and 7 (P = .000, P = .002, P = .001, P = .000, respectively). On days 3 and 7, pain scores were significantly different between different Mallampati groups (P = .049, P = .015, respectively). The flurbiprofen group required less analgesic than the placebo group during the study period on days 1, 3, 5, and 7 (P = .001, P = .001, P = .03, P = .001, respectively). Healing and side effects were not significantly different between the groups. In this study, topical use of flurbiprofen may reduce posttonsillectomy pain without any evidence of additional complications.

(363) Demonstration of clinically important relief and the percent change in pain intensity at the time of meaningful relief by flurbiprofen 8.75 mg lozenge

A lozenge containing 8.75 mg of the non-steroidal anti-inflammatory drug flurbiprofen has been developed for the treatment of sore throat. We used the double-stopwatch method to evaluate the onset of its pharmacologic activity. To determine the % pain intensity difference (PID) at the time of meaningful relief (tMR) and whether it was clinically important, we included measurements at tMR on a 100-mm linear scale, the Sore Throat Pain Intensity Scale (STPIS). At baseline, adults with recent-onset moderate/severe sore throat and tonsillo-pharyngitis rated pain on the STPIS and an 11-point numerical rating scale, the Sore Throat Scale (STS), and were randomized under double-blind conditions to one flurbiprofen or placebo lozenge. Two stopwatches were started: patients depressed one stopwatch when they first perceived any relief and the second when they experienced meaningful relief (tMR). Patients rated pain on the STS every 5 minutes and on the STPIS at tMR. For the flurbiprofen group (n=101), median tMR was 43 minutes. (For the placebo group, median tMR could not be calculated because >50% of placebo-treated patients did not report meaningful relief.) Mean reduction in STS for flurbiprofen-treated patients at 45 minutes (closest time-point to the median tMR) was 2.2, corresponding to 30% PID, consistent with a “clinically important” change on an 11-point numerical rating scale.1 Mean % PID on the STPIS at the tMR was 42%, consistent with acute pain patients’ achieving “definite improvement”2 and “much improvement”.3 These findings not only demonstrate the onset of clinically significant pharmacologic activity of flurbiprofen lozenge but also provide a framework for interpreting changes on linear and numerical rating scales that can be applied to other pain trials. (1. Farrar, J Pain Symptom Manage, 2003; 2. Schachtel, J Pain, 2013; 3. Cepeda, Pain, 2003.) Supported by a grant from Reckitt Benckiser. A lozenge containing 8.75 mg of the non-steroidal anti-inflammatory drug flurbiprofen has been developed for the treatment of sore throat. We used the double-stopwatch method to evaluate the onset of its pharmacologic activity. To determine the % pain intensity difference (PID) at the time of meaningful relief (tMR) and whether it was clinically important, we included measurements at tMR on a 100-mm linear scale, the Sore Throat Pain Intensity Scale (STPIS). At baseline, adults with recent-onset moderate/severe sore throat and tonsillo-pharyngitis rated pain on the STPIS and an 11-point numerical rating scale, the Sore Throat Scale (STS), and were randomized under double-blind conditions to one flurbiprofen or placebo lozenge. Two stopwatches were started: patients depressed one stopwatch when they first perceived any relief and the second when they experienced meaningful relief (tMR). Patients rated pain on the STS every 5 minutes and on the STPIS at tMR. For the flurbiprofen group (n=101), median tMR was 43 minutes. (For the placebo group, median tMR could not be calculated because >50% of placebo-treated patients did not report meaningful relief.) Mean reduction in STS for flurbiprofen-treated patients at 45 minutes (closest time-point to the median tMR) was 2.2, corresponding to 30% PID, consistent with a “clinically important” change on an 11-point numerical rating scale.1 Mean % PID on the STPIS at the tMR was 42%, consistent with acute pain patients’ achieving “definite improvement”2 and “much improvement”.3 These findings not only demonstrate the onset of clinically significant pharmacologic activity of flurbiprofen lozenge but also provide a framework for interpreting changes on linear and numerical rating scales that can be applied to other pain trials. (1. Farrar, J Pain Symptom Manage, 2003; 2. Schachtel, J Pain, 2013; 3. Cepeda, Pain, 2003.) Supported by a grant from Reckitt Benckiser.

A comparative study for evaluating flurbiprofen effectiveness in postoperative pain

Aim of the present study was to evaluate the effect of flurbiprofen, which is a member of non-steroidal anti-inflammatory drug group (NSAIDs), on postoperative pain treatment. From September 2013 to May 2014, total of 250 patients were surveyed to perform a systematic evaluation of postoperative pain by comparing flurbiprofen with two other kinds of NSAIDs (diclofenac and ketorolac) and isotonic saline in a double-blind, randomized, placebo-controlled study. Patients were randomized for treatment: 65 cases received flurbiprofen, 60 cases received diclofenac sodium, 60 cases received ketorolac and 65 cases received the placebo (0.9% isotonic saline) (control group). After 24-hours of surgery patients treated with flurbiprofen, ketorolac, and diclofenac showed the lowermost PPI scores compared with those treated with 0.9% isotonic saline (P&lt;0.05). Moreover, flurbiprofen-treated patients also had the lowest PRI(R)T scores (P&lt;0.05). When the pain rating index was examined by subclass, a significantly lower PRI(R)S score was detected in the flurbiprofen group at 24 hours (P&lt;0.05). However, at the 96-hour time point, no differences that were found in PPI and PRI[R] scores between the ketorolac, diclofenac, and flurbiprofen groups, whereas the control group was significantly less effective than the NSAID drugs. Flurbiprofen seemed to be the most effective NSAID for the treatment of pain after internal fixation of fracture, even though at 24 hours after surgery pain was at a maximum.DOI: http://dx.doi.org/10.3329/icpj.v4i3.21935 International Current Pharmaceutical Journal, February 2015, 4(3): 367-369