Effect of preemptive analgesia of flurbiprofen axetil on postoperative analgesia and plasma cytokines in senile patients with tumor

doi:10.3969/j.issn.1002-7386.2014.01.005

Abstract：Objective To investigate the effect of preemptive analgesia of flurbiprofen axetil on postoperative analgesia and plasma cytokines at peroperative period in senile patients with tumor .Methods 60 senile patients with tumor (ASAⅠ~Ⅱgrade selective operation ) were randomly divided into two group,with 30 patients in each group.By means of double-blind method,after trachea cannula (15min before cutting skin) the patients in the two groups were given flurbiprofen axetil 5ml (group A) or fat emulsion (group B) 5ml by intravenous injection,respectively,with PCIA pump after operation. The analgesia scoring (VAS value),adverse reaction and fentanyl dosage were recorded at 2h,12h,24h after operation.The levels of IL-6,IL-10,TNF-аand IFN-γin peripheral vein blood were detected by ELISA before anesthesia (T0),2h after operation (T1),operation end (T2),12h after operation (T3) and 24h after operation.The anesthesia time,perioperative bleeding volume,infusion volume and the dosage of remifentanil and propofol were recorded .Results The VAS scores ah,12h after operation in group A were significantly lower than those in group B ( P <0.05),however,there were no significant differences 24h after operation between two groups ( P >0.05).PCA pressing number of times,fentanyl dosage and adverse reaction in group A were significantly lower than those in group B ( P <0.05).As compared with those at T0,the serum contents of TNF-а,IFN-γat T1,T2,T3 in both groups were obviously increased ( P <0.05),moreover,which reached peak at T1.As compared with those in group B ,the serum levels of TNF-аat T1,T2,T3 in group A were significantly decreased ( P <0.05),however,the levels of IFN-γwere obviously increased ( P <0.05).As compared with those at T0,the serum levels of IL-6,IL-10 at T1,T2,T3 in both groups were significantly increased ( P <0.05),which reached peak at T2.As compared with those in group B,the serum levels of IL-6 at T1,T2,T3 in group A were significantly decreased ,however,IL-10 contents were obviously increased ( P <0.05).The four parameters at T4 in both groups approached or recovered to the levels before operation ( P <0.05).Conclusion The effect of preemptive analgesia of flurbiprofen axetil is definite on postoperative analgesia in senile patients with tumor ,which can reduce fentanyl dosage ,without increasing the incidence of adverse reaction , which can also decrease stress inflammatory reaction at peroperative period in senile patients with tumor .