Effect of Intravenous Acetaminophen and Flurbiprofen on Postoperative Pain after Lumbar Disc Surgery

Aims: Lumbar disc surgery is often associated with moderate to severe postoperative pain. Whether non-steroidal anti-inflammatory drugs or acetaminophen provides effective analgesia following lumbar disc surgery remains controversial. This study aimed to determine whether flurbiprofen produces analgesic effects equivalent to those of acetaminophen after lumbar disc surgery.

Study Design: Prospective, randomized, open-label, placebo-controlled trial

Place and Duration of Study: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo, Japan, between April 2018 and March 2019.

Methodology: We studied 76 patients who underwent elective lumbar disc surgery under general anesthesia. The patients were randomly allocated to one of three groups. Group A (n=25) received 1000 mg of acetaminophen intravenously every 6 h. Group F (n=25) received 50 mg of flurbiprofen intravenously every 6 h. Group C (n=26) received saline intravenously every 6 h as a placebo. Each drug was started before skin closure 18 h after surgery. All patients were anesthetized under total intravenous anesthesia with propofol and remifentanil and received fentanyl before skin closure. Postoperative pain was evaluated using a numerical rating scale (NRS) at 0, 1, 3, 6, 12, 18, and 24 h postoperatively. The patients were administered diclofenac sodium or loxoprofen, as rescue analgesics, as needed.

Results: There were no significant differences in patient characteristics among the three groups. There were no significant differences in NRS scores among the three groups during the study period. However, rescue analgesics were administered significantly less frequently in group F than in groups A and C over 12 h and 24 h, respectively.

Conclusion: The results of this study showed that flurbiprofen might provide more effective analgesia than acetaminophen following lumbar disc surgery.