Effects of Preemptive Analgesia with Flurbiprofen Axetil on Postoperative Cognitive Function in Elderly Patients with Hip Fracture Caused by Traffic Accident after Hip Replacement

HE Yin-bin; REN Peng-cheng; ZHANG Hai-ying

doi:10.3969/j.issn.1002-3429.2019.03.021

Abstract：Objective To investigate the effect of preemptive analgesia with flurbiprofen axetil on postoperative cognitive function in elderly patients with hip fracture caused by traffic accident after hip replacement. Methods Fifty-eight cases with hip fracture caused by traffic accident who underwent hip replacement in our hospital were selected and divided into the observation group (n=29) and the control group (n=29) according to random number table method. The control group was given conventional anesthesia induction, while the observation group was given conventional anesthesia induction and preemptive analgesia with flurbiprofen axetil. Cognitive function was assessed using the Concise Smart State Scale (MMSE) on the 1 st day before surgery, 1 st day and 3 rd day after surgery. Visual analogue scale (VAS) was used to assess the pain level at 2 h, 12 h, 24 h, and 48 h after surgery. The recovery time, extubation time and incidence of postoperative cognitive dysfunction (POCD) were observed, and the dosage of fentanyl at 24 h after surgery was recorded. Results Compared with the control group, the MMSE scores of the observation group were increased on the 1 st day and the 3 rd day after surgery, and the VAS scores were significantly decreased at 2 h, 12 h, 24 h and 48 h after surgery. The recovery time and extubation time were significantly decreased, and the dosage of fentanyl was decreased at 24 h after surgery, suggesting significant differences (P＜0.05). Compared with those on the 1 st day before surgery, the MMSE scores on the 1 st day after surgery of the two groups and the 3rd day after surgery of the control group were decreased, and the difference was statistically significant (P＜0.05). There was a statistically significant difference in the incidence of POCD between the two groups (P＜0.05). Compared with those at 2 h after surgery, the VAS scores of the two groups at 12 h after surgery and those of the control group at 24 h after surgery were increased, and the difference was statistically significant (P＜0.05). Conclusion Preemptive analgesia with flurbiprofen can effectively shorten the recovery time and extubation time, reduce the use of analgesic drugs, promote the recovery of POCD, and improve the quality of life of patients.