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Chen X, Chen P, Chen X, Huang M, Tang K, He Q. Efficacy and safety of parecoxib and flurbiprofen axetil for perioperative analgesia in children: a network meta-analysis. Front Med (Lausanne) 2023; 10:1231570. [PMID: 37529243 PMCID: PMC10387543 DOI: 10.3389/fmed.2023.1231570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/22/2023] [Indexed: 08/03/2023] Open
Abstract
Objective The aim of this study was to systematically review the efficacy and safety of parecoxib and flurbiprofen axetil for perioperative analgesia in children through Bayesian network meta-analysis. Methods We systematically searched PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, VIP, and Wanfang Data databases on 18 July 2022 to obtain randomized controlled trials comparing perioperative parecoxib or flurbiprofen with placebo or standard treatment for pediatric analgesia. The outcomes were the postoperative pain score and the incidence of adverse events. The Gemtc package of R-4.0.3 and Stata 17.0 were used for Bayesian network meta-analysis. Results We retrieved 942 articles and 49 randomized controlled trials involving 3,657 patients who met the inclusion criteria. Compared with children who received placebo treatment, those who received flurbiprofen axetil had lower pain sores at each time point within 24 h postoperatively, and those who received parecoxib had lower pain sores at each time point within 12 h postoperatively. Compared with children who received tramadol treatment, both the children who received flurbiprofen axetil or parecoxib had lower pain scores at 8 h postoperatively. The ranking results demonstrated that flurbiprofen axetil had significant superiority in reducing pain scores at 2, 4, and 12 h postoperatively, and parecoxib had significant superiority in reducing pain scores at 0, 0.5, 1, 6, 8, and 24 h postoperatively. In terms of safety, compared with children who received placebo, those who received flurbiprofen axetil or parecoxib had a lower incidence of total adverse events and postoperative agitation. Compared with tramadol, flurbiprofen axetil and parecoxib both significantly reduced the incidence of total adverse events and postoperative nausea and vomiting. Compared with flurbiprofen axetil or fentanyl, parecoxib significantly reduced the incidence of postoperative nausea and vomiting. The ranking results showed that parecoxib was advantageous in decreasing the incidence of total adverse events and postoperative nausea and vomiting. Conclusion Flurbiprofen axetil was most effective at reducing pain scores at 2, 4, and 12 h postoperatively. Parecoxib had an advantage in terms of reducing pain scores at 0, 0.5, 1, 6, 8, and 24 h postoperatively, as well as the incidence of total adverse events and postoperative nausea and vomiting. Systematic trial registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=348886, PROSPERO (CRD42022348886).
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Affiliation(s)
- Xi Chen
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Pan Chen
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao Chen
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Min Huang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Kejing Tang
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuyi He
- Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Ding C, Lei J, Cai Z, Gao M, Zou Z, Li Y, Deng J. Catalytic oxidation activation of peroxymonosulfate over Fe-Co bimetallic oxides for flurbiprofen degradation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:53355-53369. [PMID: 36854945 DOI: 10.1007/s11356-023-25914-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
In this research, FeCo2O4 nanomaterial was successfully synthesized by a typical sol-gel method and conducted as an effective agent for peroxymonosulfate (PMS) activation to eliminate antibiotics flurbiprofen (FLU), a strong nonsteroidal drug. FeCo2O4 nanomaterial was characterized by XRD, TEM, SEM, and XPS. Various characterization results proved that FeCo2O4 held stable spinel structure. The interfering factors including initial pH, PMS concentration, catalyst dosage, inorganic anions, and humic acid on FLU removal were also discussed. The conclusion was that the removal efficiency of FLU reached 98.2% within 120 min after adding FeCo2O4 (0.4 g L-1) and PMS (3 mM). The optimal pH for FLU degradation was the initial pH of 6.5; too acidic or alkaline was not conductive to the degradation. The existence of HA and Cl- restrained the degradation of FLU, and HCO3- promoted the removal, while the influence of NO3- and SO42- could not be considered. The radical scavenging experiment confirmed that •OH, O2•-, and SO4•- participated in FLU removal and SO4•- functioned a leading role. FeCo2O4 showed high efficiency for PMS activation in pH range of 3.0 to 10.0. After the fourth cycle operation, the FLU removal rate exceeded 76.9%, and the Co leaching rate was low during the catalytic reaction. This study shows that FeCo2O4 nanomaterial is an efficient and environment-friendly catalyst, which can be applied for PMS activation to remove organic pollutants in water.
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Affiliation(s)
- Chunsheng Ding
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Jia Lei
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Zhiyue Cai
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Mengying Gao
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Zhaozheng Zou
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Yuanfeng Li
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Jing Deng
- College of Civil Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.
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Wu S, Gan C, Huang X, Jiang D, Xu Y, Liao Y, Ma F, Hong Y, Duan H, Lin P. Incidence and risk factors of postoperative nausea and vomiting in lung cancer patients following lobectomy and application of analgesic pumps. J Int Med Res 2022; 50:3000605221105343. [PMID: 35735025 PMCID: PMC9235308 DOI: 10.1177/03000605221105343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the occurrence rate and risk factors of postoperative nausea
and vomiting (PONV) in lung cancer patients following lobectomy and
application of analgesic pumps. Methods This retrospective study reviewed clinical data from patients that had
undergone lobectomy for lung cancer under general anaesthesia. The risk
factors of PONV were analysed using binary logistic regression models. Results A total of 203 patients (97 females) were enrolled. The rate of PONV was
29.6% (60 of 203 patients) for all patients, 42.3% (41 of 97 patients) for
female patients and 17.9% (19 of 106 patients) for male patients. Female
patients undergoing thoracotomy (odds ratio [OR] 7.770, 95% confidence
interval [CI] 1.747, 34.568) or having surgery durations ≥120 min (OR 4.493,
95% CI 1.502, 12.851) were significantly more susceptible to PONV. The risk
of PONV in female patients that received postoperative dolasetron (100 mg,
once a day) was significantly lower (OR 0.075, 95% CI 0.007, 0.834). For
male patients, the risk of PONV was significantly lower in those with a body
mass index ≥24 kg/m2 (OR 0.166; 95% CI 0.035, 0.782). Conclusion Female and male patients have different risk factors for PONV following
lobectomy for lung cancer and application of analgesic pumps.
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Affiliation(s)
- Suwen Wu
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Chune Gan
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Xiaoling Huang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Dongping Jiang
- Department of Radiology, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Ye Xu
- Department of Anaesthesia, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Yixia Liao
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Fen Ma
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Yutong Hong
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Hao Duan
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
| | - Peng Lin
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Centre; State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine; Guangzhou, China
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Wu Y, Tian L, Li C, Liu M, Qiao S, Zhang W, Tian S, Chen G. Factors affecting sufentanil consumption for intravenous controlled analgesia after hepatectomy: retrospective analysis. BMC Anesthesiol 2021; 21:308. [PMID: 34876004 PMCID: PMC8650516 DOI: 10.1186/s12871-021-01526-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pain control after hepatectomy is usually achieved by opioids. There are significant individual differences in the amount of opioids used after hepatectomy, and the metabolism of opioids is liver-dependent. The purpose of our study was to explore the possible risk factors for opioid consumption during the first 48 h after surgery. Methods In a retrospective study design involving 562 patients undergoing open or laparoscopic hepatectomy, all patients were treated with intravenous patient-controlled analgesia (IV-PCA) along with continuous and bolus doses of sufentanil for a duration of 48 h after surgery during the time period of August 2015 and February 2019. The primary endpoint was high sufentanil consumption 48 h after hepatectomy, and patients were divided into two groups: those with or without a high PCA sufentanil dosage depending on the third quartile (Q3). The secondary endpoint was the effect of a high PCA sufentanil dosage on various possible clinical risk factors. The relevant parameters were collected, and correlation and multivariate regression analyses were performed. Results The median operation time was 185 min (range, 115–250 min), and the median consumption of sufentanil 48 h after the operation was 91 μg (IQR, 64.00, 133.00). Factors related to the consumption of sufentanil at 48 h after hepatectomy included age, operation time, blood loss, intraoperative infusion (red blood cells and fresh-frozen plasma), pain during movement after surgery (day 1 and day 2), preoperative albumin, and postoperative blood urea nitrogen. Age (≤ 60 and > 60 years), extent of resection (minor hepatic resection and major hepatic resection), surgical approach (laparoscope and open) and operation time (min) were independent risk factors for sufentanil consumption at 48 h postoperatively. Conclusion Age younger than 60 years, major hepatic resection, an open approach and a longer operation are factors more likely to cause patients to require higher doses of sufentanil after hepatectomy, and the early identification of such patients can increase the efficacy of perioperative pain management.
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Affiliation(s)
- Yue Wu
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Lina Tian
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Chunye Li
- Department of Pain, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, 212001, Jiangsu, People's Republic of China
| | - Minjun Liu
- Department of Nursing Education, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Shina Qiao
- Department of Nursing Education, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Weibo Zhang
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Suming Tian
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China
| | - Gang Chen
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejang University, 3 Qingchun Road East, ShangCheng District, Hangzhou, 310016, Zhejiang, People's Republic of China.
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Kim SY, Lee S, Lee Y, Kim H, Kim KM. Effect of single dose preoperative intravenous ibuprofen on postoperative pain and opioid consumption: a systematic review and meta-analysis. Korean J Anesthesiol 2021; 74:409-421. [PMID: 33611881 PMCID: PMC8497907 DOI: 10.4097/kja.21050] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
Background Ibuprofen, a well-known analgesic, is commonly used as a component of a multimodal analgesic approach for postoperative pain. This systematic review and meta-analysis aimed to investigate whether a single-dose preoperative intravenous ibuprofen can reduce postoperative pain and opioid consumption. Methods PubMed/MEDLINE, Embase, Cochrane Library (CENTRAL), and Web of Science databases were searched to identify relevant studies published up to May 2020. Randomized controlled trials comparing preoperative single-dose intravenous ibuprofen effect with the control group on postoperative pain and opioid consumption after surgery under general anesthesia were included. Results Six studies involving 366 participants were included. Single-dose administration of intravenous ibuprofen preoperatively significantly reduced postoperative pain score on a scale of 0-10 at 1 h (MD: -1.64, 95% CI [-2.56, -0.72], P < 0.001, I2 = 95%), at 4-6 h (MD: -1.17, 95% CI [-2.09, -0.26], P < 0.001, I2 = 94%), and 24 h (MD: -0.58, 95% CI [-0.99, -0.18], P < 0.001, I2 = 90%). Cumulative opioid consumption, presented as fentanyl equivalents, was also reduced significantly in the ibuprofen group compared to placebo group until postoperative 4-6 h (MD: -56.35 μg, 95% CI [-101.10, -11.60], P < 0.001, I2 = 91%) and 24 h (MD: -131.39 μg, 95% CI [-224.56, -38.21], P < 0.001, I2 = 95%). Conclusions Preoperative single-dose intravenous ibuprofen can reduce postoperative pain and opioid consumption until 24 h postoperatively. Considering the high heterogeneity and small number of studies included, care should be taken when generalizing these findings.
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Affiliation(s)
- Su Yeon Kim
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Sangseok Lee
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Yeji Lee
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hyunho Kim
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Kye-Min Kim
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
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Li TT, Xiong LL, Huang J, Wen S, Chen YJ, Wang TH, Liu F. The Effects of Body Mass Index on the Use of Patient-Controlled Intravenous Analgesia After Open Gastrointestinal Tumor Surgery: A Retrospective Analysis. J Pain Res 2020; 13:2673-2684. [PMID: 33116809 PMCID: PMC7588277 DOI: 10.2147/jpr.s261997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/28/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose To investigate the impact of body mass index (BMI) on the analgesic effects and adverse reactions of patient-controlled intravenous analgesia (PCIA). Methods From 2017 to 2018, 390 patients undergoing open gastrointestinal surgery were reviewed at West China Hospital, Sichuan University. All used PCIA of sufentanil combined with dexmedetomidine and flurbiprofen axetil. According to their BMIs, they were placed into six groups: group A (BMI < 18.5kg/m2, 29), group B (18.5kg/m2 ≤ BMI< 22kg/m2, 124), group C (22kg/m2 ≤ BMI < 24kg/m2, 99), group D (24kg/m2 ≤ BMI < 26kg/m2, 69), group E (26kg/m2 ≤ BMI < 28kg/m2, 46) and group F (BMI ≥28kg/m2, 23). Main data of the perioperative use of analgesics, postoperative visual analogue score (VAS), and adverse reactions were collected. Results Twenty-four hours (h) after surgery, patients in group A had a higher resting VAS than the other groups, especially B (pA-B = 0.011). VAS of patients during activity in group B was lower than those in group C 48 h after surgery (p = 0.013). Compared with groups B to F, group A had a significantly lower incidence of hypertension (p = 0.012) and a significantly higher incidence of vomiting 24 h after surgery (p = 0.009). Binary logistic analysis found that higher age was a risk factor for vomiting 24 h after surgery (OR 1.158, p = 0.045). Conclusion Using the same PCIA, patients with BMIs of less than 18.5 kg/m2 had worse analgesia on the first day after surgery and were more likely to vomit. Postoperative analgesia and related experiences in patients with BMIs of less than 18.5 kg/m2 need to be improved.
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Affiliation(s)
- Ting-Ting Li
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Liu-Lin Xiong
- School of Pharmacy and Medical Sciences, Faculty of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Jin Huang
- Laboratory Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, People's Republic of China
| | - Song Wen
- Department of Pain, Affiliated Hospital of Zunyi Medical University, Guizhou, People's Republic of China
| | - Yan-Jun Chen
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Ting-Hua Wang
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Fei Liu
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
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