Liu Yongrong, Li Bo, Hang Lihua, Zhang Li
Department of Operation Center, The Third Xiangya Hospital of Central South University, Changsha, 410013, China.
Department of Anesthesiology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Kunshan, 215300, China.
Perioper Med (Lond). 2024 Jun 18;13(1):59. doi: 10.1186/s13741-024-00419-2.
The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and postoperative acute kidney injury (AKI) remains controversial, with limited studies specifically examining flurbiprofen. Therefore, this research aimed to investigate the association between intraoperative flurbiprofen administration and postoperative AKI.
We retrospectively identified a cohort of patients at the Third Xiangya Hospital of Central South University. A total of 3882 adult patients undergoing spinal surgery between January 1, 2012, and July 31, 2018, were included and classified into two groups: those receiving flurbiprofen (50 or 100 mg once, 5 min after anesthesia start) and those not receiving flurbiprofen. The primary endpoint was the incidence of AKI.
The flurbiprofen group (4.4%) had a lower incidence of AKI compared to the non-flurbiprofen group (6.5%, P < 0.001). After adjusting for potential confounding variables, the multivariable regression analysis showed that the flurbiprofen group had a 49% reduced risk of postoperative AKI (OR 0.51; 95% CI 0.31 to 0.82) compared to the non-flurbiprofen group. Subgroup analysis indicated that flurbiprofen injection was associated with a reduced incidence of postoperative AKI in patients without diabetes (OR 0.61; 95% CI 0.19 to 0.74), surgical times of 2-5 h (OR 0.54; 95% CI 0.23 to 0.75), and preoperative anemia (OR 0.57; 95% CI 0.21 to 0.74).
The study concluded that perioperative flurbiprofen treatment was associated with a lower risk of postoperative AKI in adult patients undergoing spinal surgery.
非甾体类抗炎药（NSAIDs）与术后急性肾损伤（AKI）之间的关联仍存在争议，专门研究氟比洛芬的研究有限。因此，本研究旨在调查术中给予氟比洛芬与术后AKI之间的关联。
我们回顾性确定了中南大学湘雅三医院的一组患者。纳入了2012年1月1日至2018年7月31日期间接受脊柱手术的3882例成年患者，并将其分为两组：接受氟比洛芬的患者（麻醉开始后5分钟一次给予50或100mg）和未接受氟比洛芬的患者。主要终点是AKI的发生率。
氟比洛芬组（4.4%）的AKI发生率低于非氟比洛芬组（6.5%，P<0.001）。在调整潜在混杂变量后，多变量回归分析显示，与非氟比洛芬组相比，氟比洛芬组术后AKI风险降低49%（OR 0.51；95%CI 0.31至0.82）。亚组分析表明，氟比洛芬注射液与无糖尿病患者（OR 0.61；95%CI 0.19至0.74）、手术时间为2至5小时（OR 0.54；95%CI 0.23至0.75）以及术前贫血患者（OR 0.57；95%CI 0.21至0.74）术后AKI发生率降低有关。
该研究得出结论，围手术期使用氟比洛芬治疗与接受脊柱手术的成年患者术后AKI风险较低有关。
