Single dose oral flurbiprofen for acute postoperative pain in adults Stable (no update expected for reasons given in 'What's new')

Abstract

Abstract Background

Flurbiprofen is a non‐selective non‐steroidal anti‐inflammatory drug (NSAID), related to ibuprofen and naproxen, used to treat acute and chronic painful conditions. There is no systematic review of its use in acute postoperative pain.

Objectives

To assess efficacy, duration of action, and associated adverse events of single dose oral flurbiprofen in acute postoperative pain in adults.

Search methods

We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies to January 2009.

Selection criteria

Randomised, double blind, placebo‐controlled trials of single dose orally administered flurbiprofen in adults with moderate to severe acute postoperative pain.

Data collection and analysis

Two review authors independently assessed trial quality and extracted data. Pain relief or pain intensity data were extracted and converted into the dichotomous outcome of number of participants with at least 50% pain relief over 4 to 6 hours, from which relative risk (RR) and number needed to treat to benefit (NNT) were calculated. Numbers of participants using rescue medication over specified time periods, and time to use of rescue medication, were sought as additional measures of efficacy. Information on adverse events and withdrawals were collected.

Main results

Eleven studies compared flurbiprofen (699 participants) with placebo (362 participants) in studies lasting 6 to 12 hours. Studies were of adequate reporting quality, and most participants had pain following dental extractions.

The dose of flurbiprofen used was 25 mg to 100 mg, with most information for 50 mg and 100 mg. The NNT for at least 50% pain relief over 4 to 6 hours for flurbiprofen 50 mg compared with placebo (692 participants) was 2.7 (2.3 to 3.3) and for 100 mg (416 participants) it was 2.5 (2.0 to 3.1). With flurbiprofen 50 mg and 100 mg 65% to 70% of participants experienced at least 50% pain relief, compared with 25% to 30% with placebo. Rescue medication was used by 25% and 16% of participants with flurbiprofen 50 mg and 100 mg over 6 hours, compared with almost 70% with placebo.

Adverse events were uncommon, and not significantly different from placebo.

Authors' conclusions

Flurbiprofen at doses of 50 mg and 100 mg is an effective analgesic in moderate to severe acute postoperative pain. The NNT for at least 50% pain relief is similar to that of commonly used NSAIDs such as ibuprofen and naproxen at usual doses. Use of rescue medication indicates a duration of action exceeding 6 hours.

Author(s)

Asquad Sultan, Henry J McQuay, R Andrew Moore, Sheena Derry

Abstract

Plain language summary

Single dose oral flurbiprofen for acute postoperative pain in adults

A single dose of flurbiprofen 50 mg or 100 mg provides a high level of pain relief to 65% to 70% of those with moderate or severe postoperative pain. It has similar efficacy to other commonly used analgesics at standard doses, including ibuprofen and naproxen, with a duration of action exceeding 6 hours. Adverse events were no more common with flurbiprofen than with placebo in these single dose studies.

Author(s)

Asquad Sultan, Henry J McQuay, R Andrew Moore, Sheena Derry

Reviewer's Conclusions

Authors' conclusions

Implications for practice

Flurbiprofen at doses of 50 mg and 100 mg is an effective analgesic in acute postoperative pain, providing clinically useful levels of pain relief to 65% to 70% of those treated, compared with 25% to 30% with placebo. The NNT of 2.5 for at least 50% pain relief over 4 to 6 hours for the 100 mg dose compares favourably with that of other commonly used analgesics such as ibuprofen 400 mg. The NNTp for use of rescue medication within 6 hours, at 2.0, is lower (better) than ibuprofen, implying a longer duration of action. Flurbiprofen was well tolerated with adverse events similar to placebo.

Implications for research

Further studies at higher and lower dose would help to establish whether there is a significant dose response, and so whether using a higher dose provides additional benefit. Future studies should report median time to use of rescue medication to confirm a relatively long duration of action.

Get full text at The Cochrane Library

Single dose oral flurbiprofen for acute postoperative pain in adults Stable (no update expected for reasons given in 'What's new') is a sample topic from the Cochrane Abstracts.

To view other topics, please or .

Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. .