Effect Of Flurbiprofen Axetil On Analgesia And Stress Reaction In Resection Of Nucleus Pulposus

0bjective1. To investigate the effect of flurbiprofen axetil(FA) used as preemptive and postoperative analgesic on the plasma level of PGE2 and the serum level of CRP in resection of nucleus pulposus.2. To investigate the relationship between the plasma concentration of FP which is the active metabolin of flurbiprofen axetil(FA) and the plasma concentration of PGE2.Methods40 patients undergoing resection of nucleus pulposus were randomly divided into two groups: group FA (who underwent injection of FA,n=20) and C (control group,n=20). 1mg·kg-1 FA was injected intravenously on each patients for preemptive analgesia 15min before anesthesia . 2 mg·kg-1 FA combined with 10μg·kg-1fentanyl and 20mg azasetron plus sodium lactate Ringer's injection to 100mL in PCA pump in group FA. while in group C, the same volume of sodium lactate Ringer's injection was instead of FA 15min before anesthesia and 15μg·kg-1 fentanyl and 20 mg azasetron without FA plus sodium lactate Ringer's injection to 100mL in PCA pump for postoperative analgesia. Blood was drawn for detecting of FP , PGE2 and CRP. Compare the concentration of plasma PGE2 and serum CRP between the two groups; Analyze the relationship between FP and PGE2; Observe and register MAP and HR during operation and VAS score of pain, Ramesay sedation score on 3h,6h,15h and 24h after operation; Observe the adverse effects such as nausea and vomit .Analyze these indexes by spss 10.0.ResultsTo compare with the level 15 min before anesthesia,the level of CRP in group FA significantly increased after operation (P<0.05)and PGE2 had no significant changes during and after operation(P>0.05).While in group C, the level of CRP and PGE2 both signigficantly increased during and after operation(P<0.05).The level of CRP in group C was much higher than that of group FA after operation(P <0.05) and PGE2 in group C was much higher than that of group FA 30min after skin incision and immediately at the end of operation(P<0.05). VAS,Ramesay sedation score both had no significant differences(P>0.05). MAP in FA was significantly lower than that of C (P<0.01)on pricking of anesthesia. HR had no significant differences between the two groups on any time.MAP and HR on pricking of anesthesia, skin incision,30 min after skin incision and immediately after operation was significantly higher than that before anesthesia in both of the two groups;MAP and HR on skin incision, 30 min after skin incision and immediately after operation was significantly lower than that of pricking (P<0.01)in both of the two groups. Adverse effects in group C were much more(P<0.05), too. FP and PGE2 had no relationship .ConclutionsFlurbiprofen axetil as a preemptive and postoperative analgesic can attenuate the degree of stress reaction in lumar discectomy and reduce the dose of fentanyl and the adverse effects.