The Effect Of Flurbiprofen On Postoperative Pain And Inflammatory Response In Patients With FESS

BackgroundFunctional endoscopic sinus surgery(FESS)has the advantages of small trauma,precise curative effect,convenient operation,quick recovery and low recurrence rate,and has been widely used in the treatment of chronic sinusitis(CRS)in recent years.Postoperative pain was more common in patients with FESS,with a 64% incidence,seriously affecting their sleep and diet.in recent years,with the promotion of multimodal analgesia,the analgesic effect of nonsteroidal anti-inflammatory drugs has been paid more and more attention.Flurbiprofen ester as a nonsteroidal anti-inflammatory drug,which was advanced application can effectively inhibit cyclooxygenase(COX),reduce the synthesis of prostaglandin(PG),reduce the production and release of inflammatory factors,reduce central sensitization,reduce hyperalgesia,and thus achieve the goal of leading analgesia.ObjectiveTo investigate the effect of flurbiprofen ester advanced analgesia on postoperative pain and inflammatory response in patients with chronic sinusitis(CRS)undergoing elective functional endoscopic sinus surgery(FESS),and to provide theoretical support for patients with otolaryngology to choose appropriate analgesic methods.Methods68 patients with chronic sinusitis(CRS)with functional endoscopic sinus surgery(FESS)were randomly divided into control group and observation group according to the single and two days of operation.Based on exclusion criteria,8 cases were excluded,and finally 30 cases were enrolled in each group.The observation group was treated with 50 mg flubiprofen ester intravenously before anesthesia,and the control group was given 0.9% sodium chloride 5 mL.The changes of MAP and HR at preoperative(T0),extubation(T1),postoperative 1 hours(T2)and postoperative 6 hours(T3),postoperative 24 hours(T4)and postoperative 48hours(T5)were observed in the two groups.VAS score at extubation(T1),postoperative 1 hours(T2),postoperative 6 hours(T3),postoperative 24 hours(T4),postoperative 48 hours(T5),and restlessness score(RS)at extubation,1 min after extubation and 5 min after extubation,and the number of patients with 48 hours postoperative analgesia compressions and the incidence of adverse events were detected in the two groups,and the concentrations of hypersensitive c-reactive protein(hs-CRP),tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)at preoperative(T0),postoperative 24 hours(T4)and postoperative 48 hours(T5)were measured in both groups.ResultsWhen T1,T2,T3,T4 and T5 were observed,MAP and HR were significantly lower than those in control group(P<0.05).VAS score inT1,T2,T3,T4 and T5 in the observation group was significantly lower than that in the control group(P<0.05).The restlessness score(RS)of the observation group was significantly lower than that of the control group(P<0.05)during extubation,1 min after extubation and 5 min after extubation.There was no significant difference in the concentrations of hs-CRP,TNF-? and IL-6 between the two groups at T0(P>0.05).And the serum concentrations of hs-CRP,TNF-? and IL-6 in the two groups were significantly higher than those in T0 at T4 and T5(P>0.05),but the concentrations of serum hs-CRP,TNF-? and IL-6 in the observation group were significantly lower than those in the control group at T4 and T5(P<0.05).There was no significant difference in the incidence of postoperative dizziness and urinary retention between the two groups(P>0.05),but the incidence of nausea and vomiting in the observation group was significantly lower than that in the control group(P<0.05).ConclusionFlurbiprofen ester advanced analgesia is used in FESS patients.The analgesic effect is remarkable,which can effectively reduce the hemodynamic fluctuation of patients,reduce the degree of restlessness during extubation,reduce the incidence of postoperative nausea and vomiting,and reduce the degree of inflammatory reaction of the body.