Flurbiprofen improves dysfunction of T-lymphocyte subsets and natural killer cells in cancer patients receiving post-operative morphine analgesia.

Abstract

OBJECTIVE:

Acute pain can lead to immune dysfunction, which can be partly ameliorated by successful pain management. Opioids, which are widely used for analgesia, can result in the deterioration of immune function. This study aimed to investigate the influence of morphine with or without flurbiprofen as post-operative analgesics on the immune systems of patients undergoing gastric cancer surgery.

METHODS:

60 patients undergoing gastric cancer surgery were equally randomized into two groups. They received post-operative patient-controlled intravenous (IV) analgesia using morphine either with or without flurbiprofen. Visual analogue scale (VAS) scores, Bruggemann comfort scale (BCS) scores, morphine consumption, time of first flatus, incidence of nausea/vomiting, and T-lymphocyte subsets (CD3⁺, CD4⁺, and CD8⁺) and natural killer cells (CD3⁻CD16⁺CD56⁺) were evaluated.

RESULTS:

No significant difference was observed in the VAS scores, BCS scores, and nausea/vomiting incidence between groups. Less morphine was consumed and the time of first flatus was earlier in patients receiving morphine with flurbiprofen than morphine alone. The expression of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and CD3⁻CD16⁺CD56⁺ decreased at 2 hours after incision and, except for CD3⁻CD16⁺CD56⁺, returned to baseline at 120 hours after surgery. Moreover, the expression of CD3⁻CD16⁺CD56⁺ at 2 hours after incision and the expression of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and CD3⁻CD16⁺CD56⁺ at 24 hours after surgery were higher in patients receiving morphine with flurbiprofen than morphine alone.

CONCLUSION:

The combination of morphine and flurbiprofen ameliorates the immune depression in Tlymphocyte subsets and natural killer cells and provides a similar analgesic efficacy to morphine alone in patients undergoing gastric cancer surgery.

• Authors: Jin-Chun Shen, He-Liang Sun, Ming-Qiang Zhang, Xiao-Yu Liu, Zhong- Yun Wang, Jian-Jun Yang
• Journal: International journal of clinical pharmacology and therapeutics (Int J Clin Pharmacol Ther) Vol. 52 Issue 8 Pg. 669-75 (Aug 2014) ISSN: 0946-1965 [Print] Germany
• PMID: 24755130 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid
• Anti-Inflammatory Agents, Non-Steroidal
• Flurbiprofen
• Morphine

Topics

• Adult
• Aged
• Analgesia, Patient-Controlled (adverse effects, methods)
• Analgesics, Opioid (administration & dosage, adverse effects)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, pharmacology)
• Double-Blind Method
• Female
• Flurbiprofen (administration & dosage, pharmacology)
• Humans
• Killer Cells, Natural (drug effects, pathology)
• Male
• Middle Aged
• Morphine (administration & dosage, adverse effects)
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Stomach Neoplasms (surgery)
• T-Lymphocyte Subsets (drug effects, pathology)