Effect Of Oxycodone And Flurbiprofen Axel On Extubation And Recovery During General Anesthesia In Patients Undergoing Thyroid Surgery

Objective:This study was conducted to The purpose of this experiment to compare compare the effects of oxycodone and flurbiprofen ester on decannulation choking cough and the quality of awakening when they used in acute analgesia after thyroid surgery.Methods:From September 2021 to December 2021,60 ASA type I or TYPE II patients between the ages of 20 and 65 underwent thyroid surgery in the China-Japan Union Hospital of Jilin University.The 60 patients were divided into groups O and F on average according to the random number table method.The two groups received the same general anesthesia regimen.The inducing drugs were midazolam 0.03mg/kg,sufentanil 0.3μg/kg,propofol 2mg/kg,etomidate 0.1mg/kg and cis-atracurium 0.05mg/kg.During surgery the anesthesia was maintained with inhalation of sevoflurane 1.5%-2.5%combined with remifentanil pumping at 0.05-0.1 ug/kg/min（BIS40-60）.Appropriate vasoactive drugs were used to keep the fluctuation range of intraoperative blood pressure within 30% of the base value,and the heart rate within 50-100 beats /min.10-30 min before the end of the operation,group O was given 0.08mg/kg oxycodone（diluted to 10 m L with normal saline）intravenously,while group F was given 1mg/kg flurbiprofen ester intravenously.Sevoflurane inhalation was stopped about 10 min before the end of surgery and large flow gas washout was started,and remifentanil was stopped when sutured.Extubation can be performed when the patient is able to open eyes and nod his head according to instructions after the recovery of normal and regular spontaneous breathing and swallowing reflex.After extubation,oxygen is given by mask（oxygen flow2L/min）and sent to PACU for observation.The time of oxycodone or flurbiprofen ester administration,spontaneous respiratory recovery time,recovery time and extubation time were recorded for all patients,and the incidence of choking during extubation was observed and recorded（Minogue score）.MAP,HR and Sp O2 were recorded before induction of anaesthesia（T0）,before extubation（T1）,immediately after extubation（T2）,5 min after extubation（T3）,10 min after extubation（T4）and 30 min after extubation（T5）in the oxycodone and flurbiprofen axetil groups,respectively.VAS scores and alertness/sedation scores were performed at T3-T5.The adverse reactions were observed,and the adverse experiences such as intraoperative awareness were asked.Results:There were no statistical differences between the two groups in terms of general data,whether they smoked,the time of administration,and the length of surgery（P > 0.05）.In terms of hemodynamics,there was a statistical difference in the time before and after extubation in the two groups（P<0.05）,while there was no statistical difference in MAP,HR and SP2 at all times before and after extubation（T0-T5）（P>0.05）.In terms of extubation cough,it was statistically significant due to the different degrees of extubation cough in the two groups（Z=-2.171,p=0.030）,while the severe choking rate（improved Minogue grading> In the percentage comparison of 3）,there was a statistical gap between group O（16.7%）and group F（43.3%）（X2=5.079,P=0.024）.In terms of postoperative analgesic sedation,the difference in VAS scores for T3-T5 between the two groups（0.33±0.884 VS 1.20±1.448,0.87±1.196 VS 1.83±1.392,1.90±1.242 VS2.67 ± 1.242）between the two groups was statistically significant（P<0.05）,while the difference in the lowest OAA/S score after extubation was not statistically significant（P>0.05）.In terms of whether awakening was affected,there were no statistical differences in the time to resume spontaneous breathing function,the time to wake up,and the time of tracheal catheter extubation between the two groups（P>0.05）.Finally,there was no statistical difference between the two groups in terms of postoperative adverse reactions（P>0.05）.Conclusions:Both 0.08 mg / kg oxycodone and 1 mg / kg flurbiprofen axetil administered intravenously over 30 min before surgery achieved relatively good early postoperative analgesia for thyroidectomy patients.While giving effective analgesia,oxycodone reduced the degree of choking on tracheal extubation compared to flurbiprofen axetil and significantly relieved severe choking reactions.Also it did not affect the time and quality of awakening.