The Safety And Effectiveness Of Flurbiprofen Axetil Combined With Dexmedetomidine For Patient-controlled Intravenous Analgesia In Gynecological Laparoscopic Surgery

Part?:Compatible stability test of flurbiprofen axeil injection with dexmedetomidine hydrochloride injectionObjective:To determine the compatible stability of flurbiprofen axetil combination with dexmedetomidine for reference in clinical rational drug use.Methods:We mixed flurbiprofen axeil injection in different concentrations with dexmedetomidine hydrochloride injection,formulated in 0.9%sodium chloride injection,and placed at room temperature.Samples were taken and measured the physicochemical indexes,including properties,pH,content and related substances,as well as the average particle size?Z-Ave?,90%cumulative particle size?D90?,polymer dispersion index?PDI?and zeta potential at 0,6,12,24,30,36,48,and 60h respectively to investigate the stability of the compatible solution.Results:Within 36 hours,the various physical and chemical indications of the three proportionally compatible solutions of flurbiprofen axetil and dexmedetomidine were stable and met the standards.Conclusion:Within 36 hours,the compatibility of flurbiprofen axetil with dexmedetomidine is stable.Part?:Clinical observation of flurbiprofen axeil combined with dexmedetomidine for patient-controlled intravenous analgesia in gynecological laparoscopic surgeryObjective:To observe the analgesic effect,occurrence of related adverse reactions and patient satisfaction of flurbiprofen axetil combined with dexmedetomidine for patient-controlled intravenous analgesia in gynecological laparoscopic surgery.Methods:Sixty patients,who planned to undergo elective gynecological laparoscopic surgery under general anesthesia,aged18 to 65,ASA grade?to?,were randomly divided into flubiprofen axetil?FD?group,sufentanil?SD?group and butorphanol?BD?group,while twenty cases in each group.Group FD received flubiprofen axetil 300mg and dexmedetomidine 200?g;group SD received sufentanil 100?g and dexmedetomidine 200?g;group BD received butorphanol 8mg and dexmedetomidine 200?g.Drugs of three groups were dissolved in 100mL,with background dose of 2mL/h,controlled dose of 2mL,and the lockout time was 15min.Hemodynamic changes,static and dynamic visual analog scale?VAS?score,Ramsay sedation scale?RSS?score immediately after tracheal tube removal?T₁?,after surgery at 6h?T₂?,12h?T₃?,24h?T₄?,36h?T₅?were recorded.The pressing ratio and residual volume of analgesia pump,additional amount of analgesic,incidence of the adverse reactions such as nausea,vomiting and chills within 36h after surgery,and the satisfaction of patients with postoperative analgesia were also recorded.Results:1.There was no significant difference in age,height,weight,operation time,intraoperative usage of sufentanil and remifentanil among three groups?P>0.05?.2.Hemodynamic indicators:There was no significant difference in hemodynamic changes at each time points among three groups?P>0.05?.3.Static VAS score:There was no significant difference in static VAS score at each time points among three groups?P>0.05?.4.Dynamic VAS score:?1?Intergroup comparison:Compared with group SD and group BD,dynamic VAS score at T₂,T₃ in group FD was significantly higher?P<0.05?.Compared with group BD,dynamic VAS score at T₂,T₄,T₅ in group SD was significantly higher?P<0.05?.In addition,the difference in dynamic VAS score at the other time points among the three groups was not significant?P>0.05?.?2?Intragroup comparison:In group FD,dynamic VAS score at T₂and T₅ was significantly different from T₁,while at T₃,T₄ and T₅ was significantly lower than that at the previous time point?P<0.05?.In group SD,dynamic VAS score at T₅ was significantly lower than that at T₁ and the previous time point?P<0.05?.In group BD,dynamic VAS score at T₅ was significantly lower than that at T₁,while at T₄,T₅ was significantly lower than that at the previous time point?P<0.05?.In addition,the difference in dynamic VAS score at the other time points in each group was not significant?P>0.05?.5.RSS score:?1?Intergroup comparison:Compared with group BD,RSS score at T₂,T₃ in group FD was significantly lower?P<0.05?.In addition,the difference in RSS score at the other time points among the three groups was not significant?P>0.05?.?2?Intragroup comparison:Compared with T₁,RSS score in group FD and group SD at T₂,T₃,T₄ and T₅,while in group BD at T₅ was significantly lower?P<0.05?.In addition,the difference in RSS score at the other time points in each group was not significant?P>0.05?.6.The use of PCA pump:None of the three groups used the additional analgesic within postoperative 36h.There were no significant differences in pressing ratio and residual volume of PCA pump among three groups?P>0.05?.7.Adverse reactions:Incidence of the adverse reactions in group FD was lower than that in group BD?P<0.05?.Incidence of PONV in group FD was lower than that in group SD and group BD?P<0.05?.There were no significant differences in incidence of chill and drowsiness among three groups?P<0.05?.None of the three groups experienced respiratory depression and pruritus.8.Patients'satisfaction:Satisfaction of patients in group FD was higher than that in group BD?P<0.05?.And there were no significant differences in satisfaction of patients between the other groups.Conclusion:The combination of flurbiprofen axetil and dexmedetomidine for PCIA in gynecological laparoscopic surgery is safe,effective and improves the patients' satisfaction.