Flurbiprofen Axetil Combined with Ultrasound-Guided Intercostal Nerve Block for Preoperative Analgesia in Patients with Traumatic Multiple Rib Fractures: A Randomized Controlled Trial

Given the limitations of single-modality analgesia for rib fractures, this study aimed to determine whether combining systemic flurbiprofen axetil with a regional intercostal nerve block (ICNB) yields more effective and sustained preoperative pain relief than either technique used alone. In this single-center, randomized, double-blind, controlled trial, 150 patients scheduled for surgery were allocated to one of three groups: Group F (flurbiprofen axetil + saline ICNB), Group FB (flurbiprofen axetil + ropivacaine ICNB), and Group B (saline + ropivacaine ICNB). The primary outcome was the Visual Analog Scale (VAS) score at quiet breathing 30 min post-intervention. Secondary outcomes included VAS scores at 6, 12, 18, and 24 h, rescue analgesia requirements, diaphragmatic excursion, arterial blood gas parameters, adverse events, and patient satisfaction. The FB group demonstrated significantly lower VAS scores at 30 min than the other groups (p < 0.001), along with significantly reduced rescue analgesia requirements across most time intervals (p < 0.05). No patients in the FB group required rescue thoracic paravertebral block versus eight in Group F (p < 0.001). The FB group also showed a significantly higher sum of pain intensity difference over 0–24 h (SPID0–24h), improved diaphragmatic excursion, higher oxygenation index, and greater patient satisfaction (all p < 0.001). The overall incidence of adverse events was low, with no serious complications reported. The combination of flurbiprofen axetil and ultrasound-guided ICNB provided superior preoperative analgesia than either agent alone, reduced rescue medication needs, improved respiratory function, and enhanced patient satisfaction, with a favorable safety profile in patients with traumatic multiple rib fractures. The study protocol was registered at the Chinese Clinical Trial Registry with registration no. ChiCTR2500105786 ( https://www.chictr.org.cn ).