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Background and Purpose: Pain is the body by a special type of NOCICEPTION feel like olfaction and vision. Postoperative pain is an important factor affecting postoperative body recovery. 50-70% of the patients after experiencing pain of moderate and above. With the accumulation of pain in the study of the molecular mechanism and clinical experience, the people realize the importance of perioperative pain therapy. Postoperative pain is a noxious stimulus, serious damage to the patient's physical and mental health, can cause nausea, vomiting, bowel movements slow down, muscle cramps, thromboembolism, heart and lung complications and organ recovery delayed adverse consequences. In turn affect the patient's postoperative recovery. In addition to surgical factors and the patient's condition and other reasons, postoperative pain and stress response is a key factor in causing postoperative complications. Anesthesia can block the pain reflex arc different parts, so as to weaken or block the strong stress response. Therefore, there is a growing emphasis on the application of anesthesia and analgesic drugs effective postoperative analgesia for patients, in order to promote the rehabilitation of patients. Therefore, the management of postoperative analgesia directly affect surgical outcomes and postoperative analgesia, and now more and more attention. After a large number of studies confirm the positive and effective postoperative analgesia may reduce adverse reactions of the body, improve immune function, reduce the incidence of perioperative cardiovascular complications, promote the body recovered. The new type of NSAID for postoperative analgesia, the application of the NSAID class of drugs the analgesic can significantly reduce serum IL-6 levels, and reduce the body's stress response. The concept of preemptive analgesia Crile in 1913, based on clinical observation and the concept of preemptive analgesia. After Woolf and Wall to revisit and development. Preemptive analgesia before the pain generated incoming blocking all noxious stimuli, to prevent the treatment of peripheral and central sensitization antinociceptive effect. A large number of animal studies also showed that preemptive analgesia can improve postoperative pain threshold, reduce the amount of postoperative analgesics, to improve the management of postoperative pain. Flurbiprofen ester Lipo-carrier injection and listed in Japan in July 1992, per milliliter of emulsion containing 50mg of flurbiprofen axetil for the treatment of post-operative pain and cancer pain. Domestic and foreign scholars have conducted a lot of research, this formulations in China has also completed a Phase II clinical study Throughout scholars research focused mainly used the majority of its clinical pharmacological properties and its security, and its application preoperative and postoperative analgesia little research on the coagulation system, platelet function, whether on the patient's surgery, the amount of postoperative bleeding influential not been reported. Platelet membrane glycoprotein CD62p specific platelet surface activation markers, and fibrinogen binding key channel of thrombosis in platelet aggregation. Further specific detection by flow cytometry to study the impact of flurbiprofen axetil injection on platelet function, and provide a reference value for clinical work. The preemptive analgesia clinical study of the efficacy and safety of flurbiprofen axetil In this study, perioperative line. Due to the the flurbiprofen axetil inhibition of cyclooxygenase, reducing TXA 2 generation, may affect platelet activation and aggregation. In this study, using the flow cytometry measurement of platelet CD62p expression observed flurbiprofen axetil used in perioperative platelet function, determine its perioperative application security. Methods: ASA Ⅰ ~ Ⅱ grade, age 30 to 55 years old of medium elective surgery of anesthesia in patients 60 cases as research subjects, male 30 Li, 30 females, weight 50 ~ 75kg, all patients were using intravenous rapid induction of tracheal plug tube after total intravenous anesthesia Anesthesia was induced with midazolam 0.1 mg.kg-1, fentanyl 2 to 4ug.kg -1 , propofol 1 ~ 2mg.kg -1 vecuronium 0.1mg.k the -1 , connected after intubation anesthesia machine control breathing. Anesthesia was maintained with selection of propofol and remifentanil intravenous continuous infusion, on-demand intraoperative anesthesia was maintained with intermittent intravenous vecuronium. The two groups of patients in the intraoperative monitoring BP, ECG, SPO 2 and PatCO 2 record blood loss. The extubation surgery until the patient is fully awake into the ward. Based on use of analgesic drugs were randomly divided into 2 groups Ⅰ flurbiprofen axetil line preemptive analgesia, 30 min before the induction of anesthesia, intravenous flurbiprofen axetil the (Kaifen) 1mg.Kg-1 (diluted with saline to 10ml), group II patients to in normal saline 10ml slow intravenous. Each group of 30 patients, intraoperative continuous detection of the patient's blood pressure (BP), mean arterial pressure (MAP), heart rate (HR), electrocardiogram (ECG), pulse oxygen saturation (SpO 2 ). Before anesthesia were 30 min (T1, was not given in the flurbiprofen axetil and placebo), 6h (T2), after the end of surgery, postoperative 24h (T3), was extracted from patient venous blood 2ml as specimens measured expression of platelet CD62p . And postoperative analgesia assessed using a visual analog scale (VAS) and record postoperative adverse reactions such as nausea, vomiting, and postoperative analgesic use. SPSS10.0 statistical software are used all data points, P <0.05 was considered statistically significant. Results: 1, General Information: patient age, weight, sex, and ASA class, the difference was not statistically significant. Surgery compared to the situation: two groups of patients anesthesia induction time, and maintenance of anesthesia time, operative time, intraoperative fluid volume, blood loss, intraoperative urine output, the difference was not statistically significant (P> 0.05). 3, the analgesic effect of comparison: Comparison of postoperative VAS scores for each time point, the difference was statistically significant (P <0.05). 4, respiratory, circulatory changes (1) comparison of the MAP: postoperative time points T1 comparison, the difference was not statistically significant (P> 0.05). (2) a comparison of HR: postoperative same point in time I group II group, the difference was not statistically significant (P> 0.05). Change (3) SpO 2 , RR: two sets of the same time point compared with postoperative time points compared with T1, the difference was not statistically significant (P> 0.05). 5, adverse reactions: the group Ⅰ nausea, vomiting and other adverse reactions, Ⅱ group occurring between the two groups, the difference was not statistically significant (P> 0.05). CD62p expression in each group of patients three time points platelet significant differences in postoperative CD62p expression was significantly higher than the preoperative. The two groups of patients with the corresponding point in time platelet CD62p expression was no significant difference (P> 0.05). 7, 24 hours postoperative analgesic drug needs are different, the the II patients pethidine demand significantly more than group Ⅰ. Conclusion: flurbiprofen axetil line preemptive analgesia, can improve the patient within 24 hours of the analgesic effect, the patient's vital signs were stable. Flurbiprofen axetil for perioperative preemptive analgesia is safe, effective and feasible. 3, the flurbiprofen axetil applications is not significantly affect the aggregation of platelet activation, had no significant effect on the coagulation system, and can be safely used in the perioperative period. 4, preemptive analgesia of flurbiprofen axetil no significant gastrointestinal adverse reactions occur.
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