To compare the curative efficiency or tolerability of flurbiprofen axetil(FA) in a high dose with that in a standard dose for postoperative pain of general surgery. Methods Relevant RCTs were retrieved from PubMed, Ovid, EMBASE, the Cochrane library, CBM, and CNKI from their inceptions to July 2019. The included studies were selected according to eligibility criteria. The study design, participant characteristics, interventions, and outcomes were abstracted after assessingmethodological quality

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... of the trials. All data were analyzed by Review Manager 5.3. Results 10 studies were identified, which compared the curative effect or tolerability of FA between high and standard dose group. 500 patients were involved in this meta-analysis, with 250 patients in high dose group and 250 patients in standard dose group, respectively. Pooled analysis of VAS scores at 1, 2, 4, 6, 8, 12, and 24h showed that VAS scores at 1h(P <0.00001), at 2h (P=0.003), at 4h (P = 0.0007), at 6h (P=0.0002), at 8h (P= 0.0002), at 12h (P = 0.0001), and at 24h (P = 0.0004) in the high dose group were significantly lower than that in the standard group. Pooled analysis of BCS scores at 1, 2, 4, 6, 8, 12, and 24h showed that BCS scores at 1h (P < 0.00001), at 6h (P < 0.00001), at 12h(P=0.03), and at 24h (P=0.01) in the high dose group were significantly higher than that in the standard group. Pooled analysis showed that there was no difference in the incidence of adverse events or administrating rate of analgesics after FA treatment between high and standard dose groups (P>0.05). Conclusions In our meta-analysis, we found that FA with high dose (≥1.25 mg/kg or 100 mg) was more COX: cyclooxygenase NSAID: nonsteroidal anti-inlammatory drug RCTs: Randomized controlled trials VAS: Visual Analogue Scale BCS: Bruggrmanncomfort scale OR: odds ratio CIs: confidence intervals MD: mean difference NNT: number needed to treat Declarations Ethics approval and consent to participate No applicable. Consent for publication No applicable.