Analgesic effect of flurbiprofen axetil combined with diclofenac sodium and lidocaine in patients undergoing anorectal surgery
Zheng Lu
Guo Nan-nan
Wang Hai-li
Song Xiao-feng
Abstract：Objective To investigate the efficacy and safety of flurbiprofen axetil injection combined with diclofenac sodi-um and lidocaine injection in postoperative analgesia for patients undergoing anorectal surgery.Methods A total of 104 patients receiving various types of anorectal surgeries in Zhengzhou Central Hospital Affiliated to Zhengzhou University from May 2022 to May 2024 were selected and randomly divided into a monotherapy group and a combination group using a computer-generated random number table,with 52 in each group.The patients in the monotherapy group received intravenous infusion of flurbiprofen axetil for analgesia and those in the combination group received intramuscular injection of diclofenac sodium and lidocaine for anal-gesia based on the regimen in the monotherapy group.The analgesic effects of the two groups were assessed using the Visual Analog Scale(VAS)at 24 and 48 hours post-medication.The serum stress response indicators,cognitive function,and occurrence of adverse reactions were compared between the two groups.Results The VAS scores of the combination group at 24 and 48 hours after medication were(5.59±1.12)points and(4.36±1.21)points,respectively,which were lower than those of the monotherapy group((6.21±1.24)points and(5.54±1.42)points,respectively)(t=2.676,4.561,P=0.009,P<0.001).Preoperatively,the levels of serum cortisol(Cor),prosta-glandin(PG),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were similar between the two groups(P>0.05).At 24 and 48 hours after medication,the serum Cor levels of the combination group were(159.62±6.38)ng·L-1 and(153.57±6.64)ng·L-1,respec-tively,which were lower than those of the monotherapy group((164.33±6.49)ng·L-1 and(157.64±6.58)ng·L-1,respectively)(t=3.732,3.140,P<0.001,P=0.002.Ftime/inter-group/inter-change=98.718,16.483,2.479,Ptime/inter-group/inter-change=0.001,0.001,0.086).Similarly,the serum PG levels of the combination group at 24 and 48 hours post-medication were(29.53±6.37)pg·mL-1 and(26.38±5.36)pg·mL-1,re-spectively,which were lower than those of the monotherapy group((32.64±6.59)pg·mL-1 and(29.88±5.93)pg·mL-1,respectively)(t=2.447,3.157,P=0.016,P=0.002,Ftime/inter-group/inter-change=42.306,8.219,2.172,Ptime/inter-group/inter-change=0.001,0.004,0.116).There were no significant differences in serum IL-6 and TNF-α levels between the two groups at 24 hours post-medication(P>0.05).However,at 48 hours post-medication,the serum IL-6 and TNF-α levels of the combination group were(26.35±5.79)ng·L-1 and(17.94±4.32)ng·L-1,respectively,which were lower than those of the monotherapy group((29.63±6.07)ng·L-1 and(20.93±4.55)ng·L-1,respectively)(t=2.280,3.437,P=0.006,0.001,IL-6:Ftime/inter-group/inter-change=24.322,1.169,2.136,Ptime/inter-group/inter-change=0.001,0.281,0.120;TNF-α:Ftime/inter-group/inter-change=26.375,9.135,1.024,Ptime/inter-group/inter-change=0.001,0.003,0.360).Preoperatively,there was no difference in Mini-Mental State Examina-tion(MMSE)cognitive scores between the two groups(P>0.05).After treatment,the MMSE cognitive scores of the monotherapy group at 24 and 48 hours were(27.77±1.32)points,(26.62±1.38)points,respectively,which were higher than those of the combination group((26.64±2.35)points,(25.74±1.45)points,respectively)(t=3.023,3.170,P=0.003,0.002;Ftime/inter-group/inter-change=51.396,21.422,2.502,Ptime/inter-group/inter-change=0.001,0.001,0.084).There were no significant differences in systemic adverse reactions between the two groups after medication(P>0.05).However,the incidence of adverse reactions at the injection site in the combination group(13.46%,7/52)was higher than that in the monotherapy group(1.92%,1/52)(χ2=4.876,P<0.05).Conclusion The combination of flurbiprofen axetil injection and diclofenac sodium and lidocaine injection is more effective than flurbiprofen axetil alone in post-medication analgesia for patients undergoing anorectal surgery since it can significantly reduce pain and stress responses.However,flurbiprofen axetil monothera-py can maintain better cognitive function and has fewer adverse reactions at the injection site.
Keywords：Anorectal surgeryFlurbiprofen axetilDiclofenac sodium and lidocainePostoperative analgesiaStress responseAdverse reaction
Publication Date：2025-04-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 271-275 )