Journal of Anesthesia and Intensive Care

Volume 1, Issue 1 (2020)

Research Article - Open Access
Comparison of The Effect of Intravenous Acetaminophen and Flurbiprofen on Postoperative Pain After Total Knee Arthroplasty: A Randomized Controlled Trials

Yusuke Kasai1, Yoshiaki Terao1*, Ayako Shimazaki1, Maki Ono1, Natsuko Oji1, Makito Oji1, Tetsuya Hara2

1Department of Anesthesia, Nagasaki Rosai Hospital, 2-12-5 Setogoe, Sasebo 857-0134, Japan

2Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan

*Corresponding Author:
Yoshiaki Terao
Department of Anesthesia, Nagasaki Rosai Hospital, 2-12-5 Setogoe, Sasebo 857-0134, Japan.
Tel: +81- 956- 49-2197, Fax: +81-956-49-2358, E-mail: yoterao@nagasakih.johas.go.jp

Received date: December 11, 2020; Accepted date: December 23, 2020; Published date: December 30, 2020

Citation: Kasai Y, Terao Y, Shimazaki A, Ono M, Oji N, Oji M, et al. (2020) Comparison of The Effect of Intravenous Acetaminophen and Flurbiprofen on Postoperative Pain After Total Knee Arthroplasty: A Randomized Controlled Trials. J Anest Inten Care. 2020;1(1): 1-5.

Copyright: © 2020 Kasai Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Femoral nerve block and local infiltration anesthesia are effective in ameliorating early postoperative pain after total knee arthroplasty. However, patients can experience rebound pain after the cessation of femoral nerve block and local infiltration anesthesia. This prospective, randomized, open-label, and placebo-controlled study aimed to determine whether acetaminophen and flurbiprofen were effective analgesic adjuvants to femoral nerve block and local infiltration anesthesia after total knee arthroplasty.

Methods: This study was conducted from October 2017 to April 2019 with 75 patients who underwent total knee arthroplasty under general anesthesia. All patients were administered total intravenous anesthesia with propofol and remifentanil and received ultrasound-guided femoral nerve block with 0.25% levobupivacaine (30 mL) before surgery and local infiltration anesthesia with 0.25% levobupivacaine (30 mL) before cementing the components. Patients were randomly allocated to one of three groups: group A (n=25), which received intravenous acetaminophen 1000 mg before the end of surgery, and 6, 12, 18, and 24 h after surgery; group F (n= 25), which received flurbiprofen 50 mg; and group C (n=25), which received saline. Patients were administered diclofenac sodium, loxoprofen, or pentazocine as rescue analgesics, if needed. Postoperative pain was evaluated by the nursing staff using a numerical rating scale 0, 1, 3, 6, 12, and 24 h postoperatively.

Results: There were no significant differences in numerical rating scale of the three groups. The frequency of rescue analgesic administration was significantly lower in groups A and F than in group C.

Conclusions: Intravenous acetaminophen and flurbiprofen were equivalent and effective adjuvants to femoral nerve block and local infiltration anesthesia after total knee arthroplasty.

Trial Registration: UMIN Clinical Trials Registry database reference number: UMIN000029487. This study was registered on October 10, 2017. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view. cgi?recptno=R000033687

Keywords

Acetaminophen; Flurbiprofen; Total knee arthroplasty; Femoral nerve block, Local infiltration anesthesia.