Asian Pacific Journal of Cancer Prevention

  • 제15권24호
  • /
  • Pages.10855-10860
  • /
  • 2015
  • /
  • 1513-7368(pISSN)
  • /
  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
권호 표지
DOI QR코드

DOI QR Code

Intravenous Flurbiprofen Axetil Enhances Analgesic Effect of Opioids in Patients with Refractory Cancer Pain by Increasing Plasma β-Endorphin

  • Wu, Ting-Ting (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Wang, Zhi-Gang (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Ou, Wu-Ling (Department of Oncology, Hubei Cancer Hospital) ;
  • Wang, Jun (Department of Oncology, General Hospital of Jinan Command, People's Liberation Army) ;
  • Yao, Guo-Qing (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Yang, Bo (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Rao, Zhi-Guo (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Gao, Jian-Fei (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army) ;
  • Zhang, Bi-Cheng (1Department of Oncology, Wuhan General Hospital of Guangzhou Command, People's Liberation Army)
  • 발행 : 2015.01.22
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: The study aimed to investigate the analgesic effect of a combination of intravenous flurbiprofen axetil and opioids, and evaluate the relationship between refractory pain relief and plasma ${\beta}$-endorphin levels in cancer patients. Materials and Methods: A total of 120 cancer patients was randomly divided into two groups, 60 patients took orally morphine sulfate sustained-release tablets in group A, and another 60 patients receiving the combination treatment of intravenous flurbiprofen axetil and opioid drugs in group B. After 7 days, pain relief, quality of life improvement and side effects were evaluated. Furthermore, plasma ${\beta}$-endorphin levels were measured by radioimmunoassay. Results: With the combination treatment of intravenous intravenous flurbiprofen axetil and opioids, the total effective rate of pain relief rose to 91.4%, as compared to 82.1% when morphine sulfate sustained-release tablet was used alone. Compared with that of group A, the analgesic effect increased in group B (p=0.031). Moreover, satisfactory pain relief was associated with a significant increase in plasma ${\beta}$-endorphin levels. After the treatment, plasma ${\beta}$-endorphin level in group B was $62.4{\pm}13.5pg/ml$, which was higher than that in group A ($45.8{\pm}11.2pg/ml$) (p<0.05). Conclusions: Our results suggest the combination of intravenous flurbiprofen axetil and opioids can enhance the analgesic effect of opioid drugs by increasing plasma ${\beta}$-endorphin levels, which would offer a selected and reliable strategy for refractory cancer pain treatment.

키워드

참고문헌

  1. Alicino I, Giglio M, Manca F, Bruno F, Puntillo F (2012). Intrathecal combination of ziconotide and morphine for refractory cancer pain: a rapidly acting and effective choice. Pain, 153, 245-9. https://doi.org/10.1016/j.pain.2011.10.002
  2. Arslan D, Koca T, Akar E, Tural D, Ozdogan M (2014). Cancer pain prevalence and its management. Asian Pac J Cancer Prev, 15, 8557-62. https://doi.org/10.7314/APJCP.2014.15.20.8557
  3. Atkin N, Jackson KA, Danks RA (2010). Bilateral open thoracic cordotomy for refractory cancer pain: a neglected technique? J Pain Symptom Manage, 39, 924-9. https://doi.org/10.1016/j.jpainsymman.2009.09.011
  4. Befon S, Mystakidou K, Lyra M, Tubanakis N, Vlahos L (2000). Continuous subcutaneous octreotide in gastrointestinal cancer patients: pain control and beta-endorphin levels. Anticancer Res, 20, 4039-46
  5. Davies NM (1995). Clinical pharmacokinetics of flurbiprofen and its enantiomers. Clin Pharmacokinet, 28, 100-14. https://doi.org/10.2165/00003088-199528020-00002
  6. El-Sheikh N, Boswell MV (2004). Plasma Beta-endorphin levels before and after relief of cancer pain. Pain Physician, 7, 67-70.
  7. Facchinetti F, Nappi G, Savoldi F, Genazzani AR (1981). Primary headaches: reduced circulating beta-lipotropin and beta-endorphin levels with impaired reactivity toacupuncture. Cephalalgia, 1, 195-201. https://doi.org/10.1046/j.1468-2982.1981.0104195.x
  8. Fujii Y, Itakura M (2009). Pretreatment with flurbiprofen axetil, flurbiprofen axetil preceded by venous occlusion, and a mixture of flurbiprofen axetil and propofol in reducing pain on injection of propofol in adult Japanese surgical patients: a prospective, randomized, double-blind, placebo-controlled study. Clin Ther, 31, 721-7. https://doi.org/10.1016/j.clinthera.2009.04.014
  9. Fujii Y, Itakura M (2011). Efficacy of the lidocaine/flurbiprofen axetil combination for reducing pain during the injection of propofol. Minerva Anestesiol, 77, 693-7.
  10. Fujimoto Y, Nomura Y, Hirakawa K, et al (2012). Flurbiprofen axetil provides a prophylactic benefit against mesenteric traction syndrome associated with remifentanil infusion during laparotomy. J Anesth, 26, 490-5. https://doi.org/10.1007/s00540-012-1368-8
  11. Hao J, Wang K, Shao Y, Cheng X, Yan Z (2013). Intravenous flurbiprofen axetil to relieve cancer-related multiple breakthrough pain: a clinical study. J Palliat Med, 16, 190-202. https://doi.org/10.1089/jpm.2012.0353
  12. Hargreaves KM, Flores CM, Dionne RA, Mueller GP (1990). The role of pituitary beta-endorphin in mediating corticotropin-releasing factor-induced antinociception. Am J Physiol, 258, 235-42.
  13. Indelicato RA, Portenoy RK (2002). Opioid rotation in the management of refractory cancer pain. J Clin Oncol, 20, 348-52.
  14. Lin CP, Lin WY, Lin FS, et al (2012). Efficacy of intrathecal drug delivery system for refractory cancer pain patients: a single tertiary medical center experience. J Formos Med Assoc, 111, 253-7. https://doi.org/10.1016/j.jfma.2011.03.005
  15. Liu ZF, Chai XQ, Chen KZ (2011). Flurbiprofen axetil enhances analgesic effect of fentanyl associated with increase in $\beta$-endorphin levels. J Anesth, 25, 679-84. https://doi.org/10.1007/s00540-011-1192-6
  16. ona V (1985). Plasmatic beta-endorphin levels and thalamic surgery for pain. Neurol Res, 7, 35-8.
  17. Meuser T, Pietruck C, Radbruch L, et al (2001). Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain, 93, 247-57. https://doi.org/10.1016/S0304-3959(01)00324-4
  18. Mizushima Y, Shoji Y, Kato T, Fukushima M, Kurozumi S (1986). Use of lipid microspheres as a drug carrier for antitumour drugs. J Pharm Pharmacol, 38, 132-44. https://doi.org/10.1111/j.2042-7158.1986.tb04527.x
  19. Mystakidou K, Befon S, Hondros K, Kouskouni E, Vlahos L (1999). Continuous subcutaneous administration of high-dose salmon calcitonin in bone metastasis: pain control and beta-endorphin plasma levels. J Pain Symptom Manage, 18, 323-30. https://doi.org/10.1016/S0885-3924(99)00081-0
  20. Park KM, Lee MK, Hwang KJ, Kim CK (1999). Phospholipid-based microemulsions of flurbiprofen by the spontaneous emulsification process. Int J Pharm, 183, 145-54. https://doi.org/10.1016/S0378-5173(99)00080-0
  21. Portenoy RK, Ganae-Motan ED, Allende S, et al (2012). Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain, 13, 438-49. https://doi.org/10.1016/j.jpain.2012.01.003
  22. Robinson RL, Kroenke K, Mease P, et al (2012). Salas Burden of illness and treatment patterns for patients with fibromyalgia. Pain Med, 13, 1366-76. https://doi.org/10.1111/j.1526-4637.2012.01475.x
  23. Roszkowski MT, Swift JQ, Hargreaves KM (1997). Effect of NSAID administration on tissue levels of immunoreactive prostaglandin E2, leukotriene B4, and (S)-flurbiprofen following extraction of impacted third molars. Pain, 73, 339-45. https://doi.org/10.1016/S0304-3959(97)00120-6
  24. Sanchez R, Alexander-Sierra F, Oliveros R (2012). Relationship between quality of life and clinical status in patients with gastrointestinal cancer. Rev Esp Enferm Dig, 104, 584-91. https://doi.org/10.4321/S1130-01082012001100006
  25. Shaiova L, Sperber KT, Hord ED (2002). Methadone for refractory cancer pain. J Pain Symptom Manage, 23, 178-80.
  26. Smith TJ, Coyne PJ (2005). Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patients. J Palliat Med, 8, 736-42. https://doi.org/10.1089/jpm.2005.8.736
  27. Su C, Su Y, Chou CW, et al (2012). Intravenous flurbiprofen for post-thymectomy pain relief in patients with myasthenia gravis. J Cardiothorac Surg, 7, 98 https://doi.org/10.1186/1749-8090-7-98
  28. Takada M, Taruishi C, Sudani T, Suzuki A, Iida H (2013). Intravenous flurbiprofen axetil can stabilize the hemodynamic instability due to mesenteric traction syndrome--evaluation with continuous measurement of the systemic vascular resistance index using a $FloTrac^{(R)}$ sensor. J Cardiothorac Vasc Anesth, 27, 696-702. https://doi.org/10.1053/j.jvca.2012.11.019
  29. Tseng LF (2001). Evidence for epsilon-opioid receptor-mediated beta-endorphin-induced analgesia. Trends Pharmacol Sci, 22, 623-30. https://doi.org/10.1016/S0165-6147(00)01843-5
  30. Vendramini-Costa DB, Carvalho JE (2012). Molecular link mechanisms between inflammation and cancer. Curr Pharm Des, 18, 3831-52. https://doi.org/10.2174/138161212802083707
  31. Wu H, Chen Z, Sun G, et al (2009). Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain. J Exp Clin Cancer Res, 28, 33-43. https://doi.org/10.1186/1756-9966-28-33
  32. Xu Y, Tan Z, Chen J, Lou F, Chen W (2008). Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery. Can J Anaesth, 55, 414-22. https://doi.org/10.1007/BF03016307
  33. Yamashita K, Fukusaki M, Ando Y, et al (2006). Preoperative administration of intravenous flurbiprofen axetil reduces postoperative pain for spinal fusion surgery. J Anesth, 20, 92-5. https://doi.org/10.1007/s00540-006-0389-6
  34. Zhang WZ, Yu WJ, Zhao XL, He BX (2014). Pharmacoeconomics evaluation of morphine, ms contin and oxycodone in the treatment of cancer pain. Asian Pac J Cancer Prev, 15, 8797-800. https://doi.org/10.7314/APJCP.2014.15.20.8797
  35. Zhang Z, Zhao H, Wang C, Han F, Wang G (2011). Lack of preemptive analgesia by intravenous flurbiprofen in thyroid gland surgery: a randomized, double-blind and placebo-controlled clinical trial. Int J Med Sci, 8, 433-8.

피인용 문헌

  1. Do Resting Plasma β-Endorphin Levels Predict Responses to Opioid Analgesics? vol.33, pp.1, 2017, https://doi.org/10.1097/AJP.0000000000000389