The association of intraoperative use of flurbiprofen axetil with the incidence of postoperative shivering in patients undergoing general anesthesia: a retrospective case-control study

BACKGROUND: Postoperative shivering is a frequent complication following general anesthesia and is associated with various adverse events. Numerous strategies have been explored to prevent postoperative shivering. However, many are accompanied by side effects. Flurbiprofen axetil, which is associated with fewer side effects, may decrease the incidence of postoperative shivering. Therefore, this study was to investigate the relationship between the intraoperative administration of flurbiprofen axetil and the occurrence of postoperative shivering. METHODS: This retrospective case-control study included patients who underwent surgery with general anesthesia and were transferred to the postanesthesia care unit (PACU). Patients with postoperative shivering (cases) were matched 1:3 with those without (controls) using the following variables: type of surgery, duration of surgery, sex, and age. The study used multivariable conditional logistic analysis to explore the relationship between intraoperative flurbiprofen axetil use and postoperative shivering. RESULTS: The study included 110 cases and 330 controls. Univariate analysis revealed an inverse association between the intraoperative use of flurbiprofen axetil and postoperative shivering (OR: 0.535, 95%CI: 0.339–0.845, p = 0.007). Multivariable conditional logistic regression analysis confirmed the stability of this association (adjusted OR: 0.569, 95%CI: 0.352–0.922, p = 0.022). Sensitivity analysis further supported the consistency of these findings (adjusted OR: 0.524, 95%CI: 0.326–0.845, p = 0.008 and adjusted OR: 0.587, 95%CI: 0.370–0.933, p = 0.024). CONCLUSIONS: Our study indicated that flurbiprofen axetil was associated with a moderate reduction in the risk of postoperative shivering. Future large-scale, prospective studies are needed to validate these findings.