Application Of Flurbiprofen Combined With Intercostal Nerve Block In Thoracoscopic Surgery In Elderly Patients

Objective: To investigate the effect of flurbiprofen combined with intercostal nerves on analgesia and early cognitive function of elderly patients with thoracoscopy lung cancer after radical operation.Methods : In this study,a randomized double-blind control method was used to select 68 patients with right lung cancer who were admitted to the Department of Thoracic Surgery,Affiliated Hospital of Guilin Medical College from February 2019 to August2019,with ASA grades II to III.The methods were radical thoracoscopic radical resection of lung cancer.According to the random number table,patients were divided into study group(preoperative preoperative flurbiprofen axetil combined with postoperative intercostal nerve block)34 cases,control group 34 cases of ketorolac tromethamine combined with intercostal nerve block after operation).After entering the operating room,the two groups of patients underwent three-way verification,established venous access,appropriate fluid replenishment,routine detection of vital signs,heart rate,electrocardiogram,pulse oxygen saturation,and non-invasive cuff blood pressure./ kg flurbiprofen axetil,give 0.5-1.0mg / kg ketoprofen trometamol to the control group patients,after conventional anesthesia induction,adequate "oxygenation and denitrification",then double-lumen bronchial catheter intubation,adjust the appropriate position After ventilator mechanical ventilation,the two groups of patients were given 10% 0.75% ropivacaine 10 ml under thoracoscopy under intercostal nerve block under the direct vision.The analysis and comparison of the general data of the two groups of patients,the length of operation and the time of single lung ventilation,the amount of anesthesia for surgery,the VAS score of 6h,12 h,and 24 h after operation,the time of extubation and ICU retention time,and the incidence of delirium on 3 days.Results:(1)There was no significant difference in the general data of the two groups including gender,age,weight,smoking history,education status,and preoperative MMSE score(p> 0.05).(2)There was no significant difference in the operation time and one-lung ventilation time of 160 ± 43 min and 125 ± 35 min in the study group compared with the operation time of 152 ± 38 min and one-lung ventilation time of 117 ± 42 min in the control group(p> 0.05).There was no significant difference in the use of anesthetic drugs(including midazolam,etomidate,sufentanil,propofol,sevoflurane,etc.)in the two groups of patients(p> 0.05).(3)The VAS scores of patients in the study group at 6 hours,12 hours,and 24 hours after surgery were 1.897 ± 0.772,2.138 ± 0.693,1.690 ±0.660,which were lower than those in the control group 2.586 ± 0.825,2.793± 0.726,and 2.138 ± 0.789.Statistical significance(p <0.05).(4)The tube-taking time and ICU retention time in the study group were 100.310 ±38.829 min and 9.462 ± 2.643 h,respectively,which were significantly different from those in the control group(119.241 ± 32.090 min,11.059 ±2.338 h)(p < 0.05).(5)The incidence of delirium on the 3rd postoperative day in the study group was 6(17.4%),and the total of 10 cases(29.4%)on the 3rd postoperative day in the control group was statistically significant(p <0.05).Conclusions: The application of flurbiprofen combined with intercostal nerve block in thoracoscopic surgery in elderly patients can reduce the incidence of postoperative pain,reduce the patient’s tube time and ICU stay time,and reduce the incidence of postoperative cognitive impairment.Safe and practical method to prevent postoperative delirium.