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Abstract Background and objectives Preoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol. Methods Ninety-six patients (ASA I or II, aged 18-65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10 mL of Intralipid, and groups B, C and D received 0.5 mg.kg−1, 0.75 mg.kg−1 and 1 mg.kg−1 of FA, respectively, 10 minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The "up-and-down" method was used to calculate the EC50 of propofol. During the equilibration period, if BIS ≤ 50 (or BIS > 50), the next patient would receive a 0.5 µg.mL−1-lower (or -higher) propofol Target-Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10 minutes after FA administration, after induction, after intubation and 15 minutes after intubation. Results The EC50 of propofol was lower in Group C (2.32 µg.mL−1, 95% Confidence Interval [95% CI] 1.85-2.75) and D (2.39 µg.mL−1, 95% CI 1.91-2.67) than in Group A (2.96 µg.mL−1, 95% CI 2.55-3.33) (p = 0.023, p = 0.048, respectively). There were no significant differences in the EC50 between Group B (2.53 µg.mL−1, 95% CI 2.33-2.71) and Group A (p > 0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66 ± 6 vs. 80 ± 10 bpm, p < 0.01) and 15 minutes after intubation (61 ± 4 vs. 70 ± 8 bpm, p < 0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15 minutes after intubation than at baseline (p < 0.05). Conclusion High-dose FA (0.75 mg.kg−1 or 1 mg.kg−1) reduces the EC50 of propofol, and 1 mg.kg−1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre-administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.
Resumo Justificativa e objetivos A administração pré‐operatória de Flurbiprofeno Axetil (FA) é amplamente usada para a modulação da analgesia. No entanto, a relação entre FA e fármacos sedativos permanece obscura. Neste estudo, nosso objetivo foi investigar os efeitos de diferentes doses de FA na Concentração Efetiva mediana (CE50) do propofol. Métodos Noventa e seis pacientes (ASA I ou II, com idades de 18-65 anos) foram alocados aleatoriamente em quatro grupos na proporção de 1:1:1:1. Dez minutos antes da indução, o Grupo A (grupo controle) recebeu 10 mL de Intralipid, enquanto os grupos B, C e D receberam FA na dose de 0,5 mg.kg‐1; 0,75 mg.kg‐1 e 1 mg.kg‐1, respectivamente. A profundidade da anestesia foi medida pelo Índice Bispectral (BIS). O método up‐and‐down foi usado para calcular a CE50 do propofol. Durante o período de equilíbrio, se o valor do BIS fosse ≤ 50 ou BIS > 50, o próximo paciente tinha a infusão de propofol ajustada para uma concentração alvo‐controlada 0,5 µg.mL‐1 inferior ou superior, respectivamente. Os dados hemodinâmicos foram registrados no início do estudo, 10 minutos após a administração de FA, após a indução, após a intubação e 15 minutos após a intubação. Resultados A CE50 do propofol foi menor no Grupo C (2,32 µg.mL‐1, Intervalo de Confiança de 95% [95% IC] 1,85-2,75) e D (2,39 µg.mL‐1, 95% IC 1,91-2,67) do que no Grupo A (2,96 µg.mL‐1; 95% IC 2,55-3,33) (p = 0,023, p = 0,048, respectivamente). Não houve diferenças significantes na CE50 entre o Grupo B (2,53 µg.mL‐1, 95% IC 2,33-2,71) e o Grupo A (p > 0,05). Não houve diferenças significantes na Frequência Cardíaca (FC) entre os grupos A, B e C. A FC foi significantemente menor no grupo D do que no grupo A após a intubação (66 ± 6 vs. 80 ± 10 bpm, p < 0,01) e 15 minutos após a intubação (61 ± 4 vs. 70 ± 8 bpm, p < 0,01). Não houve diferenças significantes entre os quatro grupos na Pressão Arterial Média (PAM) em qualquer momento. A PAM dos quatro grupos foi significantemente menor após a indução, após a intubação e 15 minutos após a intubação do que na linha de base (p < 0,05). Conclusão FA em altas doses (0,75 mg.kg‐1 ou 1 mg.kg‐1) reduz a CE50 do propofol, e 1 mg.kg‐1 de FA reduz a FC durante níveis adequados de anestesia em pacientes não estimulados. Embora esse resultado deva ser investigado na presença de estimulação cirúrgica, sugerimos que a pré‐administração de FA pode reduzir a necessidade de propofol durante anestesia cuja profundidade seja monitorada pelo BIS.
Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Propofol/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Flurbiprofen/analogs & derivatives , Hypnotics and Sedatives/administration & dosage , Anesthesia , Pain, Postoperative/prevention & control , Phospholipids/administration & dosage , Blood Pressure/drug effects , Soybean Oil/administration & dosage , Drug Administration Schedule , Confidence Intervals , Flurbiprofen/administration & dosage , Elective Surgical Procedures , Electroencephalography/drug effects , Emulsions/administration & dosage , Fat Emulsions, Intravenous/administration & dosage , Remifentanil/administration & dosage , Heart Rate/drug effects , Analgesics, Opioid , Middle AgedABSTRACT
OBJECTIVE: To evaluate the efficacy, safety and economy of tramadol and hydromorphone combined with flurbiprofen axetil in the treatment of PCIA for postoperative cesarean through the empirical study, optimize the drug treatment program and provide certain evidence-based medicine and pharmacoeconomics basis for clinical use of drugs. METHODS: Included 240 cases of maternal, these maternal need to use PCIA for postoperative analgesia and meet the inclusion and exclusion criteria. The maternal samples included in the study were divided into two groups: tramadol(tramadol 2 mg •kg-1 + flurbiprofen axetil 5 mg•kg-1) and hydromorphone(hydromorphone 0.04 mg •kg-1 + flurbiprofen axetil 5 mg•kg-1). The efficacy index, safety index and cost index of the two groups were observed. The effectiveness, adverse reactions and cost data were collected. Statistical analysis and cost effectiveness analysis were used to evaluate the economic effects of the two groups. RESULTS: The analgesic effect of tramadol group was same as the hydromorphone group, but the total cost of analgesia in tramadol group was lower than that in hydromorphone group, the results of the minimum cost analysis showed that the tramadol regimen was superior and the results were stable. CONCLUSION: The PCIA regimen of tramadol group is superior to that of the hydromorphone group, considering the efficacy, safety and economy.
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OBJECTIVE:To observe analgesia,sedation effects and safety of flurbiprofen axetil combined with hydromorphone for postoperative patient-controlled intravenous analgesia (PCIA) after orthopedics surgery. METHODS:Totally 90 patients with combined spinal epidural anesthesia underwent lower limb surgery were selected from anesthesology department in the Affiliated Hospital of Chengde Medical College during May 2016-Jan. 2018. They were divided into SF group,H group and KH group according random number table,with 30 cases in each group. The postoperative PCIA pump drug liquid formula of SF group included Sufentanil citrate injection 2-3 μ g/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of H group included Hydromorphone hydrochloride injection 0.12 mg/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of KH group included Hydromorphone hydrochloride injection 0.12 mg/kg+Flurbiprofen axetil injection 50 mg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL. The operation time, intraoperative medication (epidural application frequency of additional ropivacaine,frequency of ephedrine and atropine),effective pressing times of analgesic pump and the analgesic effect of PCIA were observed in 3 groups. VAS score and Ramsay sedation score were observed 2,6,12,24,48 h after surgery. The hospital anxiety and depression scale (HAD) score,profile of mood states (POMS) score and the occurrence of ADR were observed before and after surgery. RESULTS:There was no statistical significance in operation time,epidural application frequency of additional ropivacaine or frequency of ephedrine and atropine among 3 groups (P＞0.05). The effective pressing times of analgesic pump in KH group were significantly lower than SF group and H group. The proportion of patients with excellent and good anesthesia effect in KH group was significantly higher than SF group and H group (P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). VAS score of 3 groups 48 h after surgery were significantly lower than 6, 12,24 h after surgery;that of KH group was significantly lower than SF group and H group(P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). There was no statistical significance in Ramsay score among 3 groups at different time points(P＞0.05). Before surgery,there was no statistical significance in HAD score or POMS score among 3 groups (P＞0.05). After surgery,HAD score and POMS score of KH group and H group were significantly lower than before surgery and SF group(P＜0.05);there was no statistical significance in KH group and H group,before and after surgery in SF group(P＞0.05). No vomiting,respiratory depression,pruritus and digestive tract bleeding were observed in 3 groups. The incidence of dizziness and nausea in H group and KH group were significantly lower than SF group (P＜0.05);there was no statistical significance between KH group and H group(P＞0.05). CONCLUSIONS:The flurbiprofen axetil combined with hydromorphone show good analgesic and sedative effect for PCIA after orthopedics operation,and can significantly improve emotion and mood of patients with good safety.
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Objective The objective of this study was to investigate the analgesic effect of flurbiprofen axetil and its effect on immune factors after cervical cancer surgery.Methods Ninety patients with cervical cancer undergoing laparoscopic surgery were ran-domly divided into three groups with 30 patients in each group in Zhongshan Hospital Affiliated to Dalian University from January 2016 to June 2017.The indexes of assessment were visual assessment of visual analog scale(VAS)pain assessment and postoperative adverse reaction at 2,12,24 and 48 h after operation.The levels of CD4,CD8,IL-1,IL-6,CD4/CD8 and PGEs in the serum at 12,24 and 48 h after operation were measured.Results The VAS scores in the A group were significantly lower than those in the B and C groups dur-ing 12 and 24 h after operation(P<0.05).But there were no significant differences in the levels of CD4,CD8,IL-1,IL-6,CD4/CD8 and PGEs amongst the three groups(P>0.05).The levels of IL-1 and IL-6 at 2,12 and 24 h after operation were significantly higher than those in the baseline(P<0.05).However,the levels of IL-1 and IL-6 in the C group was significantly higher than those in the A and B groups(P<0.05).Compared to before operation,the ratio of CD4/CD8 was decreased and the level of PGE2 was increased in the three groups after operation.After 24 h operation,the ratio of CD4/CD8 in the B group were significantly lower than that in the C group(P<0.05).The level of PGE2 at 12 h after operation was significantly increased in the B and C groups(P<0.05).Conclusion The combination of flurbiprofen axetil and sufentanil in the laparoscopic surgery of cervical cancer can improve postoperative analgesia and reduce adverse reactions,effectively reduce the secretion of inflammatory mediators and minor affect on cellular immune function.
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Objective To compare the effectiveness of patient-controlled intravenous analgesia with or without background infusion of dezocine plus flurbiprofen axetil injection in patients undergoing laparoscopic colorectal cancer operation. Methods Sixty patients scheduled for laparoscopic colorectal cancer surgery,35 males and 25 females,aged 18-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups:common-dose background infusion group(Group CB,n = 30),and no background infusion group(Group NB, n = 30). All patients were intravenously administered a PCA pump containing dezocine 0.6 mg/kg,flurbiprofen axetil 3 mg/kg and normal saline in a volume of 120 mL.Patients in Group CB were given background infusion rate of 2 mL/h with PCA bolus dose 2 mL,patients in Group NB were given PCA bolus dose 4 mL only.NRS scores, Ramsay sedation scores,pressing times,consumption of analgesic,supplementary analgesics,incidence of ad-verse reactions,time of first exhaust,time of first leaving bed and patients'satisfaction scores were recorded after surgery. The influence factors of time of first exhaust and time of first leaving bed were also analyzed. Results Compared with group CB,the NRS scores in group NB were higher both at rest and during movement(P<0.05), the Ramsay sedation scores in group NB were lower at 24 and 48 h after surgery(P<0.05),the pressing times in group NB were higher(P < 0.05),the consumption of analgesic in group NB were lower after surgery,and the incidence of using supplementary analgesics was higher(P < 0.05). No statistical difference was found on the in-cidence of adverse reactions between the two groups(P > 0.05). Moreover,the time of first leaving bed in group NB was longer than that in group CB(P<0.05).The satisfaction scores in group NB was lower than that in group CB(P<0.05).The main influence factors of the time of first leaving bed were gender and NRS score during move-ment at 24 h after the operation(P<0.05).The main influence factors of the time of first exhaust were age,BMI and fluid infusion volume(P < 0.05). Conclusion Postoperative patient-controlled intravenous analgesia with background infusion of dezocine and flurbiprofen axetil injection was more efficacious and satisfactory,and more suitable in postoperative pain management.
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Objective To analyze the effect of flurbiprofen axetil (FA) on blood coagulation in patients undergoing surgery through systematic review and meta-analysis.Methods PubMed,WanFang and CNKI databases were searched from their establishment to August 2017 by computer retrieval for relevant literature on the blood coagulation effect of FA.The references of the studies included were also searched by hand.Two reviewers independently screened the literature,extracted data from full-text articles,and evaluated the methodological quality of included studies.All data were analyzed by Review Manager 5.3.Results Altogether 11 studies were finally included,consisting of 10 RCTs and one case-control study,involving 643 patients undergoing surgery.The mean Jadad score for all the studies included were less than 3,suggesting low methodological quality of the studies included.The pool analysis of 4 blood coagulation indexes (prothrombin time,thrombin time,activated partial thromboplastin time and fibrinogen) and platelet count showed that there were no significant differences between the control group and flurbiprofen axetil group before treatment and at 30 min,1-2 h,6-8 h,12 h,24 h and 48 h after treatment(P ＞ 0.05).As for other outcomes like Sonoelot coagulation indexes [activated clotting time of whole blood,coagulation rate and platelet function (PF)],time to peak,mean platelet volume,maximum platelet aggregation rate,platelet aggregation rate at 1 min (PAG1),platelet aggregation rate at 5 min (PAG5) and platelet aggregation rate maximum,no significant differences were found except in one study where PF was found to be lower at 2 h after treatment in the FA group than in the control group.Conclusion Use of FA in common clinical doses is safe for postoperative analgesia,because blood coagulation may not be significantly affected.
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OBJECTIVE: To observe the effect of flurbiprofen( FPA) combined with dexamethasone on preemptive analgesia for whole lung lavage in pneumoconiosis patients. METHODS: Ninety pneumoconiosis patients who underwent whole lung lavage under general analgesia were divided into three groups by random number table method: combine treatment group,FPA group and control group,30 cases in each group. Patients in combine treatment group were given 2 mg/kg body weight( bw) of flurbiprofen axetil injection and 10 mg of dexamethasone through intravenous injection before 2 hours of surgery. Patients in FPA group were given 2 mg/kg bw of FPA axetil injection intravenously. The control group was injected with 2 m L 0. 9% sodium chloride solution. Visual Analogue Scale( VAS) score,Bruggramann Comfort Scale( BCS) score,and adverse reaction of the three groups were recorded in 2,6,8,12 and 24 hours after operation. RESULTS: The postoperative VAS and BCS scores of combine treatment group at the 5 time points after operation were lower than that of control group and FPA group respectively( P < 0. 01). The VAS score between the 5 time points presented an decreasing tendency with the increase of time in the combine treatment group( P < 0. 05),and the BCS score presented an increasing tendency with the increase of time( P < 0. 05). The adverse reaction,such as nausea,vomiting dizziness and drowsiness,sore throat and skin itching in combine treatment group was lower than that of control group and FPA group 24 hours postoperatively( P < 0. 017). CONCLUSION: The therapy of FPA combined with dexamethasone on preemptive analgesia is a safe and effective method for reducing postoperative pain of whole lung lavage in pneumoconiosis patients.
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Objective To investigate the influence of different doses of flurbiprofen axetil on neurological behavior in CCI rats.Methods All SD rats were randomly assigned to 3 groups:control group(C group),operation but without CCI,n=5;CCI group,without injection,n=5;flurbiprofen axetil (FA) group,different doses of flurbiprofen axetil were intraperitoneally administered every 12 hours for 7 days beginning on postoperative 6 hours in CCI rats (FA1 group:2mg/kg,FA2 group:4mg/kg,FA3 group:8mg/kg,FA4 group:16mg/kg),5 rats in each subgroup.The thermal withdrawal latency(TWL) and mechanical withdrawal threshold(MWT) were tested on preoperative 1,3,5 and 7 days and postoperative 1,3,5 and 7 days.Results Firstly,compared with C group[TWL:(12.396±1.144)s;MWT:(12.801±0.494)g],the TWL and MWT of CCI and FA groups[TWL:(5.645±1.144)s,(5.901±0.914)s,(6.300±0.835)s,(7.631±0.597)s,(7.894±0.526)s;MWT:(5.14±0.71)g,(5.28±0.60)g,(6.74±0.50)g,(6.74±0.25)g,(6.70±0.42)g]were significantly declined after surgery (tTWL=26.973,31.047,31.176,30.373,30.772;tMWT=44.192,48.132,51.136,54.326,46.937,all P0.05).However,the TWL and MWT of FA2 group,FA3 group and FA4 group[TWL:(6.300±0.835)s,(7.631±0.597)s,(7.894±0.526)s;MWT:(6.74±0.50)g,(6.74±0.25)g,(6.70±0.42)g] increased significantly compared with CCI group(tTWL=-3.768,-11.569,-13.867,tMWT=-3.898,-15.233,-14.801,all P0.05).Conclusion Over 4mg/kg of flurbiprofen axetil can significantly reduce the thermal hyperalgesia and mechanical allodynia in CCI rats,however,there is a ceiling effect of flurbiprofen axetil,and the dosage of 8mg/kg can provide a maximum analgesic effect.
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Objective The purpose of this study was to investigate the effect of psychological intervention and flurbiprofen axetil on the recovery period of laparoscopic surgery for sevoflurane anesthesia.Methods 100 cases of laparoscopic surgery in the First People's Hospital of Jiande City from January 2015 to December 2016 were selected.They were randomly divided into the control group and the experimental group, each with 50 cases.The induction methods of the control group and the experimental group were the same as those during the operation, and propofol and sevoflurane and remifentanil were used to maintain anesthesia.The experimental group patients before intravenous injection of 2 mg/kg flurbiprofen, psychological intervention nursing, pay attention to the psychological status of patients, strengthen the communication with patients, patients with heart to eliminate negative emotions, relieve the psychological pressure of patients.Results The incidence of restlessness before extubation was 32%in the control group,and the rate of restlessness immediately after extubation was 22%.The occurrence rate of restlessness was 56% at 5 minutes after extubation.In the experimental group, the incidence of agitation at different times was significantly lower than that in the control group, with statistical difference(P<0.05).Compared with the control group, the hemodynamics of the experimental group was more stable, and the incidence of nausea and other adverse reactions was lower, with statistical difference(P<0.05).Conclusion Laparoscopic surgery under sevoflurane anesthesia can reduce the incidence of restlessness in recovery period of a certain degree of psychological intervention combined with flurbiprofen,stable hemodynamics,reduce the incidence of adverse reactions.
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Objective: To examine the effects of perioperative intravenous administration of flurbiprofen axetil (FA) on pain associated with transrectal ultrasound-guided prostate biopsy.Methods: This was a randomized,controlled study.Eighty-one patients who underwent 12 core prostate biopsy were included in the study.The patients were randomly assigned to one of three groups (n=27 in each) by type of procedure during prostate biopsy.Group intrarectal local anesthesia (IRLA) received intrarectal 5% (0.05 g/L) lidocaine gel 60 mg, 5 minutes before the procedure alone;Group FA received intravenous flurbiprofen axetil (1 mg/kg) 1 hour before the procedure;Group IRLA+FA received intrarectal 5% lidocaine gel 60 mg, 5 minutes before the procedure and intravenous flurbiprofen axetil (1 mg/kg) 1 hour before the procedure.The patients were asked to score the pain by using visual analogue scale (VAS) in 4 situations,including when the probe was inserted (VASⅠ),during anesthesia (VASⅡ),during biopsy (VASⅢ) and 20 minutes after biopsy (VASⅣ).The findings were evaluated with analysis of variance,and the Tukey post hoc test was followed with an overall 2-tailed significance level at α =0.05.P1, P value between Group IRLA and Group FA;P2, P value between Group FA and Group IRLA +FA,P3, P value between Group IRLA and Group IRLA +FA.The bonferroni method was used to adjust the test level, α=0.017,a P value of less than 0.017 was accepted as the threshold for statistical significance.Results: No major complications,including sepsis and severe rectal bleeding,were noted in any patient.There were no differences in general condition of the patients before procedure among the 3 groups.There were statistically significant differences in VAS scores among the 3 groups in VASⅡ (5.7±2.2, 3.0±1.5,3.3±1.9,respectively,P=0.012) and VASⅢ (6.7±2.3,3.0±2.1,2.9±1.6,respectively,P=0.001).There were no differences in the pain scores among the 3 groups during probe insertion (VASⅠ, 3.2±1.0,4.1±2.1,4.2±1.7, respectively,P=5.752) and 20 minutes after biopsy (VASⅣ, 1.4±2.1,1.0±0.9,1.1±0.7,respectively,P=3.772).Between-column differences among the 3 groups were VASⅡ (P1=0.007,P2=5.655,P3=0.001,respectively) and VASⅢ(P1=0.008,P2=7.517,P3=0.001,respectively),the differences between Group IRLA and Group FA,Group IRLA and Group IRLA +FA in VASⅡ and VASⅢ were statistically significant.Conclusion:The intravenous flurbiprofen axetil was found to be more effective than intrarectal lidocaine gel alone.
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Objective To explore the safety and efficacy of dezocine combined with flurbiprofen axetil in postoperative analgesia in elderly patients undergoing upper abdominal surgery.Methods 80 patients underwent abdominalsurgery were selected.They were divided into study group(T group) and control group(C group) according to the random number table,40 cases in each group.The visual analogue scale(VAS) and Ramsay sedation score were recorded at 2h,6h,12h,24h,48h after operation,respectively.The anesthesia-related complications such as sleepiness,chills,postoperative nausea and vomiting (PONV),and pulmonary infection in 48 hours were also recorded.Results There were no statistically significant differences in the VAS score between the two groups in the resting state and the active state(t =0.287,0.436,all P ＞ 0.05).The VAS scores of T group were significantly lower than those of C group at 2h,6h,12h,24h and 48h after operation (t =4.096,4.241,5.510,6.121,5.752,3.542,3.866,4.948,5.542,4.030,all P ＜ 0.05).There were no statistically significant differences in Ramsay sedation scores between the two groups at postoperative 2h,6h,12h,24h and 48h (t =0.323,0.226,0.541,0.297,0.771,0.795,all P ＞ 0.05).There were no statistically significant differences in the incidence of drowsiness,chills,PONV,skin itching and pulmonary infection in the two groups (4 cases vs.6 cases,6 cases vs.5 cases,5 cases vs.3 cases,1 case vs.3 cases,5 cases vs.1 case,P =0.499,0.712,0.745,0.615,0.201).Conclusion The postoperative analgesic compatibility of dezocine combined with flurbiprofen axetil can effectively relieve the postoperative pain in elderly patients with upper abdominal surgery and provide good postoperative analgesic effect and does not increase the incidence of drug related complications.It is worth to promote in clinical.
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Objective To investigate the influence of pre-administration of flurbiprofen on the hyperalgesia after remifentanil anesthesia.Methods This study included a total of 96 patients with abdominal surgery in the department of general surgery of our hospital.According to the random number table method,they were divided into 4 groups (n =24).Flurbiprofen axetil 1.5 mg/kg was injected intravenously before anesthesia in groups A1 and A2,flurbiprofen axetil was not injected in-travenously before anesthesia in groups B1 and B2.Anesthesia was maintained with infusion of remifentanil 0.1 μg·kg-1 ·min-1 in groups A1 and B1 0.4 μg·kg-1 ·min-1 in groups A2 and B2. The spontaneous breathing recovery time, consciousness recovery time,extubation time and anesthesia recover period of nausea,vomiting,restlessness and pain VAS scores were recorded. Results There was no significant difference in breath recovery time,consciousness recovery time and extubation time between the four groups.VAS score (9.0±1.8)was the highest in group B2,VAS score was significantly higher than the other three groups (P <0.05).VAS score (3.1±1.1)was the lowest in group A1, which was significantly lower than the other three groups (P < 0.05 ). Conclusion Pre-application of flurbiprofen 1.5 mg/kg can reduce postoperative hyperalgesia after remifentanil anesthesia in patients undergoing abdominal surgery.
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Objective:To investigate the stability of flurbiprofen axetil lipid microspheres injection combined with 0. 9% sodium chloride injection or 5% dextrose injection, and provide theoretical basis for the clinical application. Methods:The content changes of flurbiprofen axetil in the mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection or 5% dextrose injection were determined in 5 h at 25℃ away from light, and the changes in the appearance and particle size of flurbiprofen axetil lip-id microspheres were investigated. The changes in the appearance and particle size of flurbiprofen axetil lipid microspheres in the mix-ture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection before and after freezing and thawing were also investigated. Results:The appearance, particle size and content had no significant changes in all mixtures in 5 h at 25 ℃ away from light. The appearance and particle size of flurbiprofen axetil lipid microspheres in the mixture before and after freezing and thawing had no significant changes as well. Conclusion:The mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chlo-ride injection or 5% dextrose injection is stable in 5 h away from light.
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Objective To investigate drug metabolism distribution of flurbiprofen axetil(FA) in uterine fibroids and its effect on prostaglandin E2 (PGE2).Methods A total of 86 patients with uterine fibroids from January 2014 to February 2016 in The NO.2 Hospital of Ningbo were randomly divided into control group of 44 cases and observation group of 42 cases.The control group and the observation group were given 0.9% sodium chloride solution and 1 mg/kg FA at 15 min before operation,detection of the active metabolite of FA flurbiprofen (FP),and the concentration of PGE2 in tissue homogenate was detected by ELISA.Results The observation group FP concentration of normal and tumor tissue were (0.70 ±0.13)μg/mL and (1.72 ± 0.13)μg/mL,significantly higher than the control group(0.00 ±0.00)μg/mL and (0.00 ±0.00)μg/mL, the difference was statistically significant(P<0.05), the FP concentration of tumor tissue in the observation group was significantly higher than that in the normal group, the difference was statistically significant(P<0.05), the normal tissue and tumor tissue PGE2 concentration in the observation group were (189.29 ±26.38) pg/mL and (260.01 ±46.63) pg/mL,which were significantly lower than those in the control group(210.03 ±35.22)pg/mLand(390.20 ±92.10)pg/mL, the difference was statistically significant(P<0.05), the observation group plasma FP was (5.50 ±0.72)μg/mL,significantly higher than the control group (0.00 ±0.00)μg/mL, the difference was statistically significant(P <0.05),and PGE2 was (602.38 ±84.09) pg/mL,significantly lower than the control group(920.13 ±89.05)pg/mL, the difference was statistically significant(P <0.05).Conclusion FA in the uterine fibroids have a certain distribution of targeted,can reduce the concentration of PGE2 ,so as to alleviate the pain of patients.
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OBJECTIVE:To establish a method for the determination of 1,1-ethanediol diacetate and acetic acid in flurbiprofen axetil. METHODS:Capillary gas chromatography was performed on the column of DB-FFAP capillary column by temperature pro-grammed,the inlet temperature was 150 ℃,flame ionization detector was chosen,detector temperature was 290 ℃,carrier gas was nitrogen at a flow rate of 1.0 ml/min,injection volume was 1.0 μl,and split ratio was 5∶1. RESULTS:1,1-ethanediol diacetate and acetic acid were well-separated;and the linear ranges was 0.78-19.55 g/ml(r=0.999 7)and 7.69-64.11 μg/ml(r=0.999 3),re-spectively;the limits of quantification were 0.78 μg/ml and 7.69 μg/ml,and limits of detection were 0.23 μg/ml and 2.56 μg/ml for 1,1-ethanediol diacetate and acetic acid respectively;RSDs of precision and reprocudibility tests were lower than 3%,and stability test was lower than 5%;recoveries were 97.6%-100.4%(RSD=0.94%,n=9)and 93.6%-100.4%(RSD=0.94%,n=9);and the test results for 3 batches of flurbiprofen axetil were met the specification. CONCLUSIONS:The method is simple,accurate and re-liable,and can be used for the determination of 1,1-ethanediol diacetate and acetic acid in flurbiprofen axetil.
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Objective:To investigate the relationship between flurbiprofen axetil injection and atrial fibrillation in the elderly pa-tients after cardiac surgery and underlying mechanism. Methods: A retrospective research method was applied, and the medical re-cords of 62 elderly patients with cardiac surgery were chosen and divided into the experimental group and the control group according to the different medication. After the heart surgery, fentanyl was used in the control group, and flurbiprofen was applied in the experimen-tal group. Before and after the treatment, the serum C-reactive protein levels, the incidence of postoperative atrial fibrillation, postop-erative atrial fibrillation duration, length of stay, incidence of cardiovascular disease in 6 months and adverse reactions were observed and compared between the two groups. Results:After the treatment, the serum CRP levels in the experimental group were significantly lower than those before the treatment and those in the control group after the treatment (P0. 05). Conclusion: Flurbiprofen axetil injection used after cardiac sur-gery can reduce the incidence of atrial fibrillation, which shows important clinical significance.
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OBJECTIVE:To evaluate the effects of different doses of flurbiprofen axetil on analgesia effects of patients after laparoscopic cholecystectomy. METHODS:120 patients undergoing laparoscopic cholecystectomy were selected and randomly divid-ed into group A,B and C,with 40 cases in each group. Group A,B and C were given the mixture 100 ml of flurbiprofen axetil 100,150 and 200 mg combined with tramadol 600 mg and ondansetron 4 mg respectively and 0.9% Sodium chloride injection for patient controlled intravenous analgesia(PCIA)at the end of operation. Mean arterial pressure(MAP),heart rate(HR)and static and dynamic visual analogue scale(VAS)scores were observed in 3 groups at the end of operation,4,8,24 and 36 h after sur-gery. The incidence of incision pain,neck-shoulder pain and hypochondrium,the occurrence of ADR were recorded 36 h after oper-ation. RESULTS:After operation,There was no statistical significance in comparison of 3 groups with MAP,HR,static and dynam-ic VAS(P>0.05),4,8,24,and 36 h after operation,MAP,HR,static and dynamic VAS score of group B and C decreased sig-nificantly,there was statistical significance,compared with group A(P0.05). After operation,the incidence of incision pain,neck-shoulder pain and hypochon-drium in group A were significantly higher than group B and C,with statistical significance(P0.05). After operation,the incidence of ADR in group A and B were significantly lower than in group C,with statistical significance(P0.05). CONCLUSIONS:Flurbiprofen axetil 150 mg combined with tramadol 600 mg and ondansetron 4 mg can improve he-modynamics and patient controlled intravenous analgesia in patients underwent laparoscopic cholecystectomy with lower incidence of ADR.
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Objective To explore the targeted distribution of flurbiprofen axetil (FA) in hysteromyoma and its influence on prostaglandin E2 (PGE2).Methods A total of 40 female patients undergoing myomectomy (ASA-Ⅱ) were enrolled in the present study. The patients were randomly divided into blank control group and FA groups of three different doses. The four groups were injected with normal saline, 0.5, 1, or 1.5 mg/kg of FA 15 min before the operation. Tumor tissues and normal tissues were collected by surgical operation and the sampling time was recorded. The concentration of flurbiprofen (FP), which was the active metabolite of FA, was detected in the tumor tissues and normal tissues by HPLC. The concentrations of PGE2 were detected by ELISA in the two samples. Results FP was not detected in the tumor tissues or normal tissues of the blank group. With the increase of FA dose in the three groups, the concentration of FP had an increasing tendency in the tumor tissues, with significant differences found among the three groups (P 0.05). The concentrations of FP in the tumor tissues were significantly higher than those in the normal tissue in the three FA groups (P2 had a tendency to decrease in the tumor tissues; and there were significant differences between blank group and 1, 1.5 mg/kg FA groups (P 2 in the tumor tissues were significantly higher than those in the normal tissues in the four groups (P 0.05). Conclusion FA has a certain targeted distribution in hysteromyoma and can reduce the level of PGE2.
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OBJECTIVE: To prepare stable flurbiprofen axetil lipid microsphere for intravenous injection. METHODS: The optional formulation and prepared procedure were obtained through the single factor and crosscut design of experiment, and the stability constant of centrifugation Ke, particle size, Zeta potential, the pH of the product were studied. RESULTS: The optional formulation and procedure were 10% soybean oil for intravenous injection, 1.2% soybean lecithin, 0.6% F68, 0.4% oleic acid, 2.0% glycerol and 90% water for injection. pH was adjusted to 8.0 before homogenization and the sample was homogenized at a pressure of 80 MPa for 6 times. Finally, the lipid microspheres were sterilized for 15 min by sterilizing at 121°C and exhibited good stability after sterilization. The content of Flurbiprofen Axetil lipid microspheres was 95.59%. CONCLUSION: The preparation process is feasible to prepare lipid microsphere with good physical stability.
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Objective To compare the analgesia effect and the safety of Flurbiprofen Axetil (FA) and Parecoxib Sodium (PS) after posterior lumbar fusion surgery. Methods 90 patients undergoing internal fixation of lumbar spine randomly assigned to 3 groups:those in Group A(n = 30) received 100 mg of FA; those in Group B (n=30) received 40 mg of PS and those in Group C received saline.The VAS scores of 2, 6, 12, 24, 48, 72 h after operation and the dose of tramadol hydrochloride (TH) used and the side effect was recorded respectively. Results Group A and B had significantly better analgesic effect than Group C(P<0.05). Group A and B had lower average dose of TH than Group C (P<0.05). The VAS scores in Group A was lower than that in Group B in 2 h after the surgery. The VAS scores after the surgery showed no significant difference between Group A and B in 6 , 12, 24 h after the surgery. The VAS scores in Group A was higer than that in Group B in 48,72 h after the surgery. Conclusion Both PS and FA can alleviate postoperative pain and have fewer adverse reactions.