Effect of flurbiprofen axetil analgesia after knee replacement on the cytokine contents in serum and joint fluid as well as HPA axis activity

Objective: To investigate the effect of flurbiprofen axetil analgesia after knee replacement on the cytokine contents in serum and joint fluid as well as HPA axis activity. Methods: Patients who underwent knee replacement in People's Hospital of Dongxihu District between April 2015 and January 2018 were selected as the research subjects and randomly divided into the experimental group who accepted flurbiprofen axetil combined with patient-controlled intravenous analgesia and the control group who accepted patient-controlled intravenous analgesia alone. The contents of cytokines and HPA axis-related hormones in serum were measured before surgery as well as 1 d and 3 d after surgery;the contents of cytokines in joint fluid were measured 1 d and 3 d after surgery. Results: Compared with those of same group before surgery, NGF, NPY, TNF-α, IL-2, IL-4, IL-10, ACTH, COR, INS, GH and PRL levels of both groups were increasing 1 d and 3 d after surgery, and NGF, NPY, TNF-α, IL-2, IL-4, IL-10, ACTH, COR, INS, GH and PRL levels in serum as well as PGE2, OPN, TGF-β1, FGF21, CXCL12 and YKL-40 in joint fluid of experimental group 1 d and 3 d after surgery were lower than those of control group. Conclusion: Flurbiprofen axetil analgesia after knee replacement can reduce the release of cytokines in serum and joint fluid, and inhibit the activity of HPA axis, and its analgesic effect is exact.

Effect of flurbiprofen axetil intervention before induction on incision pain and inflammatory stress response after orthopedic surgery

Objective:To study the effect of flurbiprofen axetil intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: A total of 86 cases of elderly patients who underwent operative treatment of femoral neck fracture in Guangyuan Hospital of Traditional Chinese Medicine between March 2014 and December 2017 were selected as the research subjects. All patients were randomly divided into the experimental group who accepted flurbiprofen axetil intervention before induction + routine anesthesia induction and maintenance, and the control group who accepted routine anesthesia induction and maintenance, and each group included 43 cases. The pain levels of the two groups were assessed 24 h after surgery;the levels of pain mediators and inflammatory stress molecules in serum as well as the expression intensity of inflammatory stress molecules in peripheral blood were determined before surgery and 24 h after surgery.Results:24 h after surgery, serum SP, NPY, PGE2, TNF-α, IL-1β, IL-18, ACTH, COR and NE levels as well as peripheral blood NF-κB, NLRP3, Caspase-1, GLUT4 and FOXP3 expression intensity of both groups were significantly higher than those before surgery, and NRS pain score, serum SP, NPY, PGE2, TNF- , IL-1β, IL-18, ACTH, COR and NE levels as well as peripheral blood NF-κB, NLRP3, Caspase-1, GLUT4 and FOXP3 expression intensity of experimental group 24 h after surgery were significantly lower than those of control group.Conclusions:Flurbiprofen axetil intervention before induction can improve and inhibit the incision pain and inflammatory stress response after orthopedic surgery.

Effect of flurbiprofen axetil pretreatment on the pain degree as well as stress hormone and mediator secretion after abdominal surgery

Objective:To study the effect of flurbiprofen axetil pretreatment on the pain degree as well as stress hormone and mediator secretion after abdominal surgery.Methods: Patients undergoing abdominal surgery in our hospital between May 2015 and March 2017 were selected and randomly divided into two groups, intervention group received flurbiprofen axetil pretreatment combined with routine intravenous anesthesia, and the control group only accepted conventional intravenous anesthesia. The levels of pain neurotransmitters and cytokines, stress hormones and mediators in serum were detected before operation as well as 12 h and 24 h after operation.Results: 12 h and 24 h after operation, serum NPY, SP, Glu, TNF-α, IL-2, IL-6, IL-10, ACTH, Cor, Ins, NE and E levels of both groups of patients were significantly higher than those before operation while SOD, GHS-Px and HO-1 levels were significantly lower than those before operation, and serum NPY, SP, Glu, TNF-α, IL-2, IL-6, IL-10, ACTH, Cor, Ins, NE and E levels of intervention group 12 h and 24 h after operation were significantly lower than those of control group while SOD, GHS-Px and HO-1 levels were significantly higher than those of control group.Conclusion:Flurbiprofen axetil pretreatment can reduce the pain degree and stress response after abdominal surgery.

Flurbiprofen axetil promotes neuroprotection by activation of cerebral peroxisome proliferator-activated receptor gamma after focal cerebral ischemia in rats

Background Our previous papers indicate that flurbiprofen axetil （FA）, a cyclooxygenase inhibitor, is a promising therapeutic strategy for cerebral ischemia in rats. This study aimed to investigate whether FA could promote a neuroprotective effect by activation of peroxisome proliferator-activated receptor-y （PPAR-y） after focal cerebral ischemia in rats. Methods Totally 48 male Sprague-Dawley （SD） rats were randomly assigned into six groups （n=8 in each group）： animals in group ischemia/reperfusion （I/R） only received 120-minute transient middle cerebral artery occlusion （tMCAO）; animals in group I/R ＋FA were administered FA （10 mg/kg） by caudal vein just after 120-minute tMCAO; animals in group I/R ＋FA＋GW9662 were administered GW9662 （a PPAR-Y inhibitor, 1 mg/kg） intraperitoneally 30 minutes before cerebral ischemia onset and FA （10 mg/kg） by caudal vein just after 120-minute tMCAO; animals in group I/R ＋GW9662 were administered GW9662 （1 mg/kg） intraperitoneally 30 minutes before cerebral ischemia onset; animals in group I/R ＋DMSO were administered 3% DMSO （vehicle of GW9662, 1 ml/kg） intraperitoneally 30 minutes before cerebral ischemia onset; animals in sham group experienced the identical surgery apart from the insertion of the nylon filament. The neurologic deficit score （NDS） were performed at 72 hours after reperfusion, and then mean brain infarct volume percentage （MBIVP） was determined with 2,3,5-triphenyltetrazolium chloride （TTC） 10 g/L staining. Results NDS was significantly increased in group I/R＋FA （12.0 （10.0-15.0））, group I/R＋FA＋GW9662 （10.0 （8.0-12.0））, and in group I/R＋FA＋DMSO （12.0 （9.0-14.0）） at 72 hours after reperfusion compared with those in group I/R （7.5 （6.0-10.0））. NDS was conspicuously different between group I/R＋FA （12.0 （10.0-15.0）） and group I/R＋FA＋GW9662 （10.0 （8.0-12.0））. MBIVP in group I/R （（45.82±8.83）%） was significantly greater than that in group I/R＋FA （（23.52±9.90）%）, group I/R＋FA＋GW9662 （（33.17±7.15）%）; MBIVP in group I/R＋FA （（23.52±9.90）%） was significantly smaller than that in group I/R＋FA＋GW9662 （（33.17±7.15）%）. Conclusions FA confers the neuroprotective effect on tMCAO in rats and the selective PPAR-Y antagonist GW9662 attenuates the effect of FA. FA could promote a neuroprotective effect by, or in part, activation of PPAR-y after focal cerebral ischemia in rats.

Therapeutic time window of flurbiprofen axetil＇s neuroprotective effect in a rat model of transient focal cerebral ischemia

Background The neuroprotective effect of the cyclooxygenase （COX） inhibitor has been demonstrated in acute and chronic neurodegenerative processes. But its function under cerebral ischemic conditions is unclear. This study was designed to evaluate the neuroprotective efficacy of emulsified flurbiprofen axetil （FA, COX inhibitor） and its therapeutic time window in a model of transient middle cerebral artery occlusion （MCAO） in rats. Methods Forty-eight male SD rats were randomly assigned into six groups （n=8 in each group）; three FA groups, vehicle, sham and ischemia/reperfusion （I/R） groups. Three doses of FA （5, 10 or 20 mg/kg, intravenous infusion） were administered just after cerebral ischemia/reperfusion （I/R）. The degree of neurological outcome was measured by the neurologic deficit score （NDS） at 24, 48 and 72 hours after I/R. Mean brain infarct volume percentage （MBIVP） was determined with 2,3,5-triphenyltetrazolium chloride （TTC） staining at 72 hours after I/R. In three other groups （n=8 in each group）, the selected dosage of 10 mg/kg was administrated intravenously at 6, 12 and 24 hours after I/R. Results The three different doses of FA improved NDS at 24, 48 and 72 hours after I/R and significantly reduced MBIVP. However, the degree of MBIVP in the FA 20 mg/kg group differed from that in FA 10 mg/kg group. Of interest is the finding that the neuroprotective effect conferred by 10 mg/kg of FA was also observed when treatment was delayed until 12-24 hours after ischemia reperfusion. Conclusion COX inhibitor FA is a promising therapeutic strategy for cerebral ischemia and its therapeutic time window could last for 12-24 hours after cerebral ischemia reperfusion, which would help in lessening the initial ischemic brain damage.

Preemptive analgesic effects of flurbiprofen axetil in patients undergoing radical resection of esophageal carcinoma via the left thoracic approach

Background Systemic non-steroidal anti-inflammatory drugs have been evaluated for their possible preemptive analgesic effects.The efficacy of flurbiprofen axetil for preemptive analgesia in patients undergoing radical resection of esophageal carcinoma via the left thoracic approach needs further investigation.The aim of this study was to research the preemptive analgesic effects of flurbiprofen axetil in thoracic surgery,and the influence of preoperative administration on postoperative respiratory function.Methods This randomized,double-blind,controlled trial enrolled 60 patients undergoing radical resection of esophageal carcinoma via the left thoracic approach.Anesthesia management was standardized.Each patient was randomly assigned to receive either 100 mg flurbiprofen axetil intravenously 15 minutes before incision （PA group） or intravenous normal saline as a control （C group）.Postoperative analgesia was with sufentanil delivered by patient-controlled analgesia pump.Postoperative sufentanil consumption,visual analog scale pain scores,plasma levels of interleukin-8,and oxygenation index were measured.Results Compared with the preoperative baseline,postoperative patients in the PA group had no obvious increase in pain scores （P 〉0.05）,but patients in the C group had significantly increased pain scores （P〈0.05）.Pain scores in the C group were significantly higher at 24 hours postoperatively than preoperatively.Intergroup comparisons showed lower visual analog scale scores at 2-24 hours postoperatively in the PA group than the C group （P 〈0.05）.Sufentanil consumption and plasma interleukin-8 levels at 2 and 12 hours postoperatively were significantly lower in the PA group than the C group （P 〈0.05）.The oxygenation index at 2 and 12 hours postoperatively was significantly higher in the PA group than the C group （P〈0.05）.Conclusions Intravenous flurbiprofen axetil appears to have a preemptive analgesic effect in patients undergoing radical resection of esophageal carcinoma via the left thoracic approach,and appears to contribute to recovery of respiratorv function and to reduction of the postoperative inflammatory reaction.

Analgesic effect of parecoxib and flurbiprofen axetil for patients undergoing laparoscopic cholecystectomy and their influences on platelet aggregation

It is known that opioids produce postoperative analgesia, while it can also cause, especially in large doses, side effects like nausea, vomiting, constipation, syncope, skin itching, urinary retention and even respiratory inhibition. These factors have all greatly limited its clinical use for treating postoperative pain. Meanwhile, non-steroidal anti-inflammatory drugs （NSAIDs） play an increasingly important role in postoperative analgesia. Some studies suggest that NSAIDS may be neural protective in cerebral ischemic conditions.

Effects of Preemptive Analgesia with Flurbiprofen Axetil Injection on Analgesia, Inflammatory Response, Stress Response and Immune Response in Patients Undergoing Thoracoscopic Lobectomy

Objective:To investigate the effect of preemptive analgesia withflurbiprofen axetil injection on the analgesic effect,inflammatory response,stress response and immune response in patients undergoing thoracoscopic lobectomy.Methods:92 patients with early non-small cell lung cancer who underwent thoracoscopic lobectomy from January 2016 to March 2018 in our hospital were divided into observation group and control group according to the method of random digital table,46 cases in each group.The control group was given routine perioperative analgesia,the observation group was given advanced analgesia mode,and the visual simulation scoring method(visual)was used to observe the patients in the two groups at 4,12,24 and 48 h after operation The results showed that the level of inflammation factor,stress response factor and immune response were significantly higher than that of before operation(T0),when anesthesia woke up(T1),12 hours after operation(T2),24 h after operation(T3)and 48 h after operation(T4).Results:(1)The VAS score of the observation group was significantly lower than that of the control group(P<0.05)at 4,12,24 and 48 h after operation;(2)The levels of IL-6,IL-10,SP-A and TNF-αin the two groups were significantly lower than that of the control group(P<0.05)The level of factor-α,TNF-α)was higher than that of to time point,and showed an upward trend;the level of IL-6,IL-10,TNF-α,SP-A decreased gradually at T3,T4 time points,the level of IL-6,TNF-α,SP-A in T1,T2,T3,T4 time points in the observation group was lower than that of the control group,and the level of IL-10 was higher than that of the control group(P<0.05);(3)Compared with T0 time point,the epinephrine(EPIPH)at T1,T2,T3,T4 time points in the two groups The levels of rine,e,noradrenaline,NE and cortisol in the observation group increased first and then decreased;the levels of E,NE and cor in the observation group were lower than those in the control group at T1,T2,T3 and T4 time points(P<0.05);and(4)Compared with T0 time point,the serum IgG,IgM and IgA levels in the two groups decreased gradually at T1,T2,T3 and T4 time points,but the observation group The levels of IgG,IgM and IgA in serum of group A were higher than those of group B(P<0.05).Conclusion:Preemptive analgesia with flurbiprofen axetil injection can significantly improve the postoperative pain,reduce the level of ;inflammation,reduce the stress response and increase the level of immune response.

氟比洛芬酯对胸腔镜右肺叶切除术患者单肺通气期间肺功能的影响

目的观察氟比洛芬酯对胸腔镜右肺叶切除术患者采用封堵器行单肺通气期间肺氧合功能、呼吸力学及肺部并发症的影响。方法选择择期全麻下行胸腔镜右肺叶切除术采用封堵器行单肺通气的患者60例,男25例,女35例,年龄35~64岁,BMI 18~28 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:氟比洛芬酯组(F组)和对照组(C组),每组30例。F组在麻醉诱导前15 min静注氟比洛芬酯1.0 mg/kg,C组不予处理。于麻醉诱导前20 min(T_(0))、单肺通气30 min(T_(1))、单肺通气60 min(T_(2))、双肺通气15 min(T_(3))时抽取桡动脉血行血气分析,计算氧合指数(OI)并记录SpO_(2)。记录T_(1)、T_(2)时的气道峰压(Ppeak)、气道平台压(Pplat)、肺动态顺应性(Cdyn)和无效腔气量与潮气量之比(V_(D)/V_(T))。记录单肺通气期间低氧血症发生情况、补救例数、术后转ICU例数、术后72 h内肺不张、急性肺损伤和肺炎发生情况。结果与C组比较,F组T_(1)时SpO_(2)、T_(1)—T_(3)时PaO_(2)和OI、T_(1)、T_(2)时Cdyn明显升高(P<0.05);T_(1)、T_(2)时Ppeak和V_(D)/V_(T)、T_(2)时Pplat明显降低(P<0.05)。两组无一例单肺通气期间发生低氧血症和补救、术后转入ICU、术后72 h内发生肺不张、急性肺损伤和肺炎。结论对胸腔镜右肺叶切除术采用封堵器行单肺通气的患者,麻醉诱导前静注氟比洛芬酯有助于改善单肺通气期间肺氧合功能,优化呼吸力学参数。

氟比洛芬酯复合利多卡因用于妇科腹腔镜手术的麻醉效果研究

目的:探讨氟比洛芬酯复合利多卡因用于妇科腹腔镜手术的麻醉效果。方法:选取2020年10月至2022年10月于四川绵阳四〇四医院择期行腹腔镜手术的132例患者,采用单双号法分为对照组和联合组,各66例。麻醉诱导前10 min,对照组患者静脉注射0.9%氯化钠注射液10 mL,联合组患者双通道泵入氟比洛芬酯1.0 mg/kg+利多卡因1.0 mg/kg,术中持续输注利多卡因1.0 mg/(kg·h)至手术结束。比较两组患者术中用药剂量、脑电双频指数,术后(4、6和12 h)镇痛质量,术后12 h血清应激反应指标[肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)]水平及术后24 h内不良反应发生情况。结果:联合组患者瑞芬太尼、丙泊酚总用量显著低于对照组;联合组患者插管前1 min、插管后1 min及插管后5 min的脑电双频指数显著低于对照组;术后4、6和12 h,联合组患者疼痛程度评分显著低于对照组,舒适度评分显著高于对照组;术后12 h,两组患者E、NE及Cor水平均较术前显著升高,但联合组患者的E、NE及Cor水平显著低于对照组,上述差异均有统计学意义(P<0.05)。术后24 h内,联合组、对照组患者的不良反应总发生率分别为4.55%(3/66)、7.58%(5/66),差异无统计学意义(P>0.05)。结论:氟比洛芬酯复合利多卡因预防性镇痛可有效提高妇科腹腔镜手术患者的麻醉镇痛质量,减轻机体围手术期应激反应,且使用安全。

氟比洛芬酯与丙泊酚复合麻醉对老年肺癌肺叶切除术患者肺氧合功能、血流动力学及呼吸顺应性的影响

目的分析氟比洛芬酯与丙泊酚复合麻醉对老年肺癌肺叶切除术患者围术期肺氧合功能、血流动力学及呼吸顺应性的影响。方法选取2020年1月—2022年6月行肺叶切除术的老年肺癌100例为研究对象,根据围术期麻醉方式的不同分为观察组和对照组,每组50例。观察组在单肺通气前实施氟比洛芬酯与丙泊酚复合麻醉,对照组在单肺通气前实施丙泊酚全凭静脉麻醉。比较2组术中丙泊酚用量,不同时间点[麻醉诱导前(T1)、单肺通气30 min(T2)、单肺通气60 min(T3)及术毕(T4)]肺氧合功能指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(OI)]、血流动力学指标[平均动脉压(MAP)、心率(HR)]及呼吸顺应性指标[动态肺顺应性(Cdyn)]的变化情况,以及术后并发症发生情况。结果观察组术中丙泊酚用量(110.32±3.89)mg明显少于对照组(168.21±4.86)mg(P<0.01)。T1和T4时,2组PaO_(2)、PaCO_(2)、OI、MAP、HR、Cdyn比较差异均无统计学意义(P>0.05);与T1时比较,2组在T2和T3时PaO_(2)、PaCO_(2)、OI、HR及Cdyn均明显降低,MAP明显升高(P<0.05);其中观察组T2和T3时PaO_(2)、OI及Cdyn高于对照组,MAP、HR明显低于对照组(P<0.05,P<0.01)。观察组术后并发症总发生率18.00%(9/50)低于对照组54.00%(27/50)(P<0.01)。结论对行单肺通气下肺癌肺叶切除术的老年患者应用氟比洛芬酯与丙泊酚复合麻醉效果确切,可明显减少术中丙泊酚用量,改善患者围术期肺氧合功能及血流动力学,提高患者呼吸顺应性,有效保护肺功能,且安全性较好。

氟比洛芬酯预处理对于羟考酮复合丙泊酚在无痛纤维支气管镜检查术中应激反应的影响研究

目的研究氟比洛芬酯预处理对于羟考酮复合丙泊酚在无痛纤维支气管镜检查术中血流动力学以及应激反应的影响。方法90例无痛纤维支气管镜检查者,采用前瞻性研究方法,按随机数字表法分为A、B、C组,每组30例。A组:检查前5 min静脉滴注5 ml生理盐水,检查前静脉注射羟考酮0.1 mg/kg,丙泊酚2 mg/kg;B组:检查前5 min静脉滴注5 ml生理盐水,检查前静脉注射羟考酮0.08 mg/kg,丙泊酚2 mg/kg;C组:检查前5 min静脉滴注50 mg氟比洛芬酯,检查前静脉注射羟考酮0.06 mg/kg,丙泊酚2 mg/kg。三组术中丙泊酚恒定输注,若术中患者体动则静脉追加丙泊酚30~50 mg。比较三组患者不同时间点[麻醉诱导前5 min(T0)、用药后即刻(T1)、喉罩置入后1 min(T2)、插入纤维支气管镜后1 min(T3)、纤维支气管镜取出后1 min(T4)、完成检查后5 min(T5)]血流动力学指标[经皮血氧饱和度(SpO_(2))、舒张压(DBP)、收缩压(SBP)、心率(HR)],不同时间点(T0、插入纤维支气管镜后3 min、T5)应激以及炎症反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、肾上腺素(E)、去甲肾上腺素(NE)],不良反应(呛咳、低氧血症及喉、支气管痉挛)发生情况。结果T0、T4、T5时,三组SBP、DBP、HR、SpO_(2)比较差异无统计学意义(P>0.05);T2时,三组SpO_(2)比较差异无统计学意义(P>0.05);T1、T3时,三组SpO_(2)比较差异有统计学意义(P<0.05);T1、T2、T3时,三组SBP、DBP、HR比较差异有统计学意义(P<0.05)。T0时,三组NE、E、TNF-α、IL-6比较差异无统计学意义(P>0.05);插入纤维支气管镜后3 min、T5时,B组NE、E、TNF-α、IL-6均高于A组、C组,差异有统计学意义(P<0.05)。A组低氧血症、呛咳及喉、支气管痉挛发生率分别为20.00%、6.67%、3.33%,B组分别为3.33%、20.00%、6.67%,C组分别为3.33%、3.33%、3.33%。与A组比较,B组、C组低氧血症发生率明显降低,差异有统计学意义(P<0.05);与B组相比,C组呛咳发生率明显降低,差异有统计学意义(P<0.05);三组喉、支气管痉挛发生率比较,差异无统计学意义(P>0.05)。结论氟比洛芬酯预处理对羟考酮复合丙泊酚在无痛纤维支气管镜检查术中有助于缓解患者的应激反应,术中血流动力学更稳定,可使不良反应和麻醉药物剂量减少。

舒芬太尼联合氟比洛芬酯在功能性内窥镜鼻窦手术后患者静脉自控镇痛中的应用效果观察

目的探讨舒芬太尼联合氟比洛芬酯在功能性内窥镜鼻窦手术(FESS)后患者静脉自控镇痛(PCIA)中的应用效果。方法选取78例FESS患者为研究对象,按随机数字表法分为对照组和观察组,各39例。对照组行舒芬太尼PCIA,观察组行舒芬太尼联合氟比洛芬酯PCIA。对比两组镇痛效果、镇静效果、应激反应、PCIA使用情况及不良反应发生率。结果观察组术后3、6、12 h时视觉模拟评分法(VAS)评分为(3.58±0.42)、(2.39±0.32)、(1.85±0.24)分,Ricker镇静-躁动评分(SAS评分)为(4.24±0.45)、(3.46±0.37)、(2.83±0.22)分,均低于对照组的(4.12±0.51)、(3.08±0.41)、(2.31±0.29)分和(4.95±0.59)、(4.01±0.38)、(3.39±0.35)分(P<0.05);观察组术后24 h时皮质醇(COR)、去甲肾上腺素(NE)、促肾上腺皮质激素(ACTH)水平分别为(181.62±18.74)μg/L、(230.14±25.59)ng/L、(10.12±1.53)ng/L,均低于对照组的(204.36±19.75)μg/L、(251.52±26.43)ng/L、(12.96±1.62)ng/L(P<0.05);观察组按压次数、实际有效进药次数分别为(7.41±1.12)、(4.15±0.67)次/24 h,少于对照组的(9.69±1.27)、(5.25±1.05)次/24 h(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论舒芬太尼联合氟比洛芬酯在FESS患者术后PCIA中应用价值高,可提高患者镇痛、镇静效果,减轻机体应激反应,减少PCIA按压次数,安全可靠。

不同剂量氟比洛芬酯复合地佐辛在老年宫腔镜手术超前镇痛中的应用效果

目的探讨不同剂量氟比洛芬酯复合地佐辛在老年宫腔镜手术超前镇痛中的应用效果。方法选取2022年2月至2023年2月收治的136例拟行宫腔镜手术的老年患者为研究对象,以随机数字表法将其分为对照组和观察组,各68例。对照组采取50 mg氟比洛芬酯复合地佐辛麻醉,观察组采取100 mg氟比洛芬酯复合地佐辛麻醉。比较两组的麻醉效果。结果术毕清醒时、术后10 min,观察组的呼吸频率、心率及平均动脉压均高于对照组(P<0.05)。术后4、8、12、24 h,观察组的视觉疼痛模拟量表(VAS)评分低于对照组(P<0.05);术后4、8、12 h,观察组的Ramsay镇静评分低于对照组(P<0.05)。术后4、8、12 h,观察组的舒适度量表(BCS)评分高于对照组(P<0.05)。术后12、24 h,观察组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论100 mg氟比洛芬酯+10 mg地佐辛在老年宫腔镜手术超前镇痛中的应用效果较好。

氟比洛芬酯联合地佐辛对老年全髋关节置换术患者的疗效研究

目的 探讨氟比洛芬酯联合地佐辛对老年全髋关节置换术患者应激反应和炎症因子的影响。方法 根据随机抽签法将2021年3月—2023年3月武夷山市立医院收治的130例老年全髋关节置换术患者分为观察组(n=65)与对照组(n=65)。2组均采用静脉全身麻醉,对照组以地佐辛超前镇痛,观察组采取氟比洛芬酯联合地佐辛超前镇痛。对比2组患者的术后苏醒质量、疼痛程度、应激反应指标、炎症反应指标和不良反应。结果 观察组术后2、6、12、24 h的视觉模拟评分量表(visual analogue scale,VAS)分别为(6.09±0.98)分、(4.12±0.80)分、(2.29±0.57)分、(1.26±0.33)分,低于对照组的(6.85±1.03)分、(4.79±0.85)分、(2.80±0.62)分、(1.71±0.42)分(P <0.05)。观察组术后苏醒质量指标均优于对照组(P<0.05)。术后24 h,观察组应激反应肾上腺素(adrenaline,AD)、去甲肾上腺素(norepinephrine,NE)、皮质醇(cortisol,Cor)水平均低于对照组(P<0.05)。术后24 h,观察组炎症因子白介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平均低于对照组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 老年全髋关节置换术患者采用氟比洛芬酯联合地佐辛具有良好的镇痛效果,能够提高患者苏醒质量,抑制应激反应水平,改善炎症反应,安全性良好。

右美托咪定与氟比洛芬酯在老年全膝关节置换术患者超前镇痛中的应用效果对比

目的 对比分析右美托咪定与氟比洛芬酯在老年全膝关节置换术患者超前镇痛中的应用效果。方法选取2020年12月至2022年4月项城市中医院收治的140例拟行全膝关节置换术治疗的老年患者作为研究对象,按照不同超前镇痛方法将其分为右美托咪定组(70例)和氟比洛芬酯组(70例),右美托咪定组患者麻醉诱导前采用1.5μg/kg右美托咪定进行超前镇痛,氟比洛芬酯组患者麻醉诱导前采用1.0 mg/kg氟比洛芬酯进行超前镇痛,对比观察两组患者血流动力学指标以及疼痛、镇静评分和不良反应发生情况。结果 T_(1-6)时,右美托咪定组患者心率(HR)、平均动脉压(MAP)均明显低于氟比洛芬酯组(HR:t=8.034、6.937、2.673、3.003、8.398、9.002,P<0.001、P<0.001、P=0.008、P=0.003、P<0.001、P<0.001;MAP:t=8.593、8.187、8.178、12.376、9.141、11.299,P均<0.001)。除术后2 h右美托咪定组患者视觉模拟评分法(VAS)评分与氟比洛芬酯组无明显差异(t=0.271,P=0.787)外,术后4、8、16、32 h右美托咪定组患者VAS评分均明显低于氟比洛芬酯组(t=4.894、4.950、6.081、4.932,P均<0.001)。术后2、4、8、16、32 h,右美托咪定组患者Ramsay镇静评分均明显高于氟比洛芬酯组(t=3.636、5.966、4.104、6.246、6.999,P均<0.001)。右美托咪定组患者不良反应发生率为4.29%,与氟比洛芬酯组患者的不良反应发生率7.14%无明显差异(χ~2=0.133,P=0.716)。结论 老年全膝关节置换术中应用右美托咪定进行超前镇痛,能够有效维持血流动力学稳定性,镇痛、镇静效果好,且无明显不良反应发生,安全性较高。

非布司他片治疗痛风伴高尿酸血症的效果

目的 研究与分析不同治疗方式对痛风伴高尿酸血症患者的影响。方法 筛选2021年3月至2023年3月期间在焦作市人民医院就诊的92例痛风伴高尿酸血症患者进行研究。以随机数法分为两组,每组46例。其中参照组以别嘌呤醇治疗,治疗组以非布司他片治疗,对比两组治疗效果,炎性因子与尿酸水平,不良反应,生活质量。结果 治疗组治疗有效率高于参照组,差异有统计学意义(P <0.05);治疗前两组炎性因子与尿酸水平对比,差异无统计学意义(P> 0.05),两组治疗后3个月、6个月肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、尿酸(UA)水平均较治疗前降低,且同时段治疗组低于参照组,差异有统计学意义(P <0.05);治疗组不良反应发生率低于参照组,差异有统计学意义(P<0.05);两组治疗后6个月生活质量评分高于治疗前,且治疗组高于参照组,差异有统计学意义(P<0.05)。结论 非布司他片能显著改善痛风合并高尿酸血症症状及UA、sICAM-1、TNF-α水平,临床疗效确切,并且安全性高,可提高患者生活质量。

多模式镇痛在胸腰椎骨折患者围手术期的应用及效果分析

目的 探讨多模式镇痛在胸腰椎骨折患者围手术期的应用效果,为胸腰椎骨折患者围手术期镇痛提供一种可靠的方式.方法 选取2020年10月~2023年8月于我院行手术治疗的胸腰椎骨折患者50例,随机分为对照组(n=25)及多模式镇痛组(n=25),患者按各组内用药方案给予镇痛治疗,比较两组手术前后的视觉模拟评分法(VAS)评分、C反应蛋白(CRP)水平、白细胞介素-6(IL-6)水平、平均住院时间、不良反应发生情况、阿片类药物使用情况.结果 多模式镇痛组术后1 d、术后3 d、术后7 d的VAS评分明显低于对照组,差异有统计学意义(P<0.05).两组患者术后1 d的血清CRP、IL-6水平均上升,多模式镇痛组低于对照组,差异有统计学意义(P<0.05);术后3 d两组的血清CRP、IL-6水平均下降,多模式镇痛组低于对照组,差异有统计学意义(P<0.05).多模式镇痛组平均住院时间显著少于对照组(P<0.05).两组不良反应发生情况比较,差异无统计学意义(P>0.05);多模式镇痛组曲马多的平均使用剂量少于对照组,差异有统计学意义(P<0.05).结论 多模式镇痛可减轻胸腰椎骨折患者术后的疼痛程度,缩短平均住院时间.

不同厂家氟比洛芬酯注射液有效性和安全性的真实世界研究

目的基于真实世界数据评价不同厂家氟比洛芬酯注射液治疗术后疼痛的有效性和安全性。方法纳入2019年1月—2020年12月南京大学医学院附属鼓楼医院骨科、普外科术后使用氟比洛芬酯注射液镇痛的患者,按照氟比洛芬酯注射液的厂家将患者分为A组(江苏省集采中选药物)和B组(非江苏省中选药物)。对比两组患者术后6,24,48和72 h静息或活动时的疼痛程度、睡眠质量和药物不良反应情况。结果研究共纳入患者1009例,使用倾向性评分匹配(PSM)平衡基线后纳入患者470例(每组各235例)。A组对比B组,疼痛控制良好患者比例较低(55.7%和74.0%,P<0.01);术后6 h静息、6 h活动、24 h静息、48 h静息、72 h静息状态下VAS评分均较高(2.5±1.6比1.6±1.3,P<0.01;3.2±1.6比2.8±1.2,P=0.003;1.6±1.4比1.25±1.17,P=0.008;1.0±1.1比0.7±0.9,P=0.002;0.7±1.2比0.5±0.8,P=0.002);术后镇痛药物疗效不足进行补救的次数上升(0.5±1.1比0.2±0.5,P<0.01);睡眠质量良好的患者比例上升(87.7%比80.4%,P=0.032)。两组安全性指标差异无统计学意义。结论两厂家氟比洛芬酯注射液安全性相似,但A厂家药品有效性不如B厂家药品。

剖宫产术后两种镇痛方案临床疗效及经济学比较

目的为临床剖宫产术后镇痛方案的选择提供参考。方法选取医院2020年6月至2021年4月剖宫产术后拟使用静脉泵镇痛的产妇80例,按镇痛方案的不同分为A组B组,各40例,分别经静脉泵予地佐辛注射液15~20 mg及枸橼酸舒芬太尼注射液45~100μg,均联合氟比洛芬酯注射液100~150 mg,静脉泵速率2 mL/h,给药24 h;比较两种方案的镇痛效果、患者满意度及不良反应发生率。采用成本-效果分析法对两种方案进行经济学评价,并以敏感性分析评估经济学评价结果的可靠性。结果两组产妇术后6 h、12 h、24 h、48 h静息与活动状态下的疼痛数字评分量表(NRS)评分均无显著差异(P>0.05),A组术后24 h NRS评分达标率为75.00%,与B组的70.00%相当(P>0.05)。两组各有2例产妇(5.00%)追加镇痛药物。A组与B组满意度(97.50%比92.50%,P>0.05)及不良反应发生率(17.50%比12.50%,P>0.05)均相当。成本-效果分析结果显示,A组每多获得1单位有效率需花费18.54元,与B组的成本-效果比为57.24。敏感性分析结果显示,A组相对B组的增量成本-效果比为51.52。结论剖宫产术后采用本研究中两种镇痛方案均有良好的镇痛疗效与安全性,但氟比洛芬酯与舒芬太尼联合相较与地佐辛联合更具有经济学优势。