The Clinical Observation Of Flurbiprofen As Pre-emptive Analgesic Used In Patients Undergoing Craniotomy

IntroductionPost-craniotomy pain has received more concerntration recerntly.More and more literatures and reserches have shown that it can not be ignored.If not solved correctly,it would causes agitation,shivers and hypertension which increases mortality rate of intracranial hemorrhage brain swelling.Postoperative pain has been associated with traumas of surgery and the use of analgesics perioperatively.Surgical trauma can cause pathological inflammatory response and injury,wich induces inflammatory pain and neuropathic pain.These series of responses would induce peripheral sensitization and central sensitization,which are important machnisms of postoperative pain.Peripheral sensitization play a promoting role of central sensitization.Prostaglandins represented as PGE₂ play a enhancing role of peripheral sensitization.Now,pre-emptive analgesia is defined as:to take certain measures to prevent the nerve endings and central nervous system sensitizing before the nociceptive stimulation,then eliminate or reduce the postoperative pain.Flurbiprofen ester is a new type of non-selective non-steroidal anti-inflammatory and analgesic drugs,with targeted,sustained-release characteristics.Preoperative application of flurbiprofen ester can effectively inhibit the arachidonic acid pathway of prostaglandin produced,thus inhibits peripheral sensitization and cantral sensitization.Flurbiprofen preemptive analgesia for clinical research has been reported in the literature and obtained Desired effect.This reserch is to observe the effect of flurbiprofen as preemptive analgesic used in patients undergoing craniotomy and it's relative adverse reactions in patients undergoing selective craniotomy.ObjectivesTo observe the effect of flurbiprofen as preemptive analgesic and it's relative adverse reactions in patients undergoing selective craniotomy.Materials and MethodsForty patients undergoing selective craniotomy were divided into two groups randomly by age,sex,location of craniotomy:observation group(Group-flurbiprofen) and control group(Group-saline).Monitored sonoclot signal and estimate bleeding amount during the operation.Evaluated the quality of emergence after operation.Recorded the VAS pain scores 2 hours,6 hours,12 hours and 24 hours after operation,and the occurrence of adverse reactions as nausea,vomiting and respiratory depression.ResultsThe concentration of prostaglandin E₂(PGE₂) in the serum of the observation group is lower than that of control group(P＜0.05).There were no significant differences in ACT(activated coagulation time) and CR(clot rate) of the two groups(P＞0.05),but the PF(platelet function) of observation group was lower than that of cntrol group(P＜0.05).There were no significant differences in awakening time and extubation time of the two groups(P＞0.05).The 2 hours' pain scores of the two groups was of no significant difference(P＞0.05),but the pain scores of observation group were lower than that of control group in 6 hours,12 hours and 24 hours after operation(P＜0.05).The occurrence of nausea,vomoting and respiratory depression had no significant differences(P＞0.05). ConclusionFlurbiprofen as preemptive analgesic could reduce the postoperative pain in patients undergoing craniotomy,without increasing the occurrence of nausea,vomoting and respiratory depression.It could effect the platelet function,but could not increase the amount of bleeding.