Comparison of perioperative flurbiprofen axetil or celecoxib administration for pain management after total-knee arthroplasty: A retrospective study

Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. The purpose of this study was to evaluate the postoperative pain relief, time to ambulation, and opioid-sparing effects of flurbiprofen axetil (FA) and celecoxib (CX) after total-knee arthroplasty (TKA) surgery. A convenience sample of 300 patients was obtained using a retrospective chart review of patients who underwent TKA and received FA or CX or saline (SA) as control. Institutional review board approval was obtained, and 300 charts of patients who received TKA were reviewed. Visual analog scale (VAS) pain scores up to 6 months postoperatively, opioid requirements, range of knee motion, adverse effects, and length of hospital stay are recorded. Data were analyzed using the Pearson Chi-square where appropriate or the Fisher exact test, and all continuous variables were examined using a Wilcoxon rank test. The results of the study showed no significant differences between the 3 groups for the age, gender, American Society of Anesthesiologists class, number of patients who underwent knee surgery, weight, height, and operation duration. Patients in FA and CX demonstrated significantly reduced pain scores and less morphine consumption at rest and active motion compared to SA in 24 hours after surgery, with lower scores and less opioid requirements in the FA group. However, after 48 hours postoperatively, there are no significant differences between these groups. Intravenous application of 1 mg/kg flurbiprofen axetil twice a day and 200 mg celecoxib once a day improved analgesia and decreased morphine consumption following TKA. When the 2 active drugs were compared, it was found that flurbiprofen axetil was superior to celecoxib in terms of short-term analgesic efficacy and opioid consumption.