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...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.展开更多
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 respira...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.展开更多
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. Thi...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.展开更多
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 ...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.展开更多
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 lobe...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.展开更多
基金This study was supported by the National Natural Science Foundation of China (No.30872433).
文摘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.
文摘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.
基金This study was supported by a grant from the National Nature Science Foundation of China (No. 30872445).
文摘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.
基金This study was supported by a grant from the National Natural Science Foundation of China (No. 30872445).
文摘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.
文摘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.