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Purpose:To observe the effect of flurbiprofen axetil combined with fentanyl for preventing anesthesia agitation after gastric and colonic operations.Method:60 patients at ASAⅡ～Ⅲlevel have undergone gastric or colonic operations with general anesthesia and at an opted time. Age of patients ranged at 35～79 years old; weight of patients ranged at 45～90kg. There was no long-term opioid medication history, or neurological system disease history, or epileptic disease history among patients. Patients with any one of the following conditions were excluded from the study:those with peptic ulcer, serious hematologic diseases, serious abnormal functioning of heart, liver or kidney, serous high blood pressure, and those having historical allergy to any component of the pharmaceutical under study, having aspirin asthma history, having intubation difficulty and those having used blood transfusion as the operation required. Patients were randomly divided into three groups with 20 people in each group. Group A were treated with fentanyl, Group B flurbiprofen axetil, and Group C fentanyl and flurbiprofen axetil. After settling the patients in the operation room, open the veins on the back of hand, then infuse 0.9% sodium chloride parenteral solution. Use a standard multifunctional monitor instrument to monitor the following indicators: electrocardiogram (ECG), non-invasive blood pressure (BP), respiration rate (RR), and pulse oximetric saturation (SpO2). All patients were treated with the same anesthesia method; they all received rapid induced general anesthesia, and the anesthesia were purely and entirely maintained through veins. Twenty minutes prior to the operation, Group A received fentanyl 1.5ug/kg, Group B received flurbiprofen axetil 1.0mg/kg, and Group C received fentanyl 1.5ug/kg and flurbiprofen axetil 1.0mg/kg. Heart rate and blood pressure were recorded at these time points:before the anesthesia,1 h after the operation,5 minutes before the extubation, during extubation, and 5 minutes after the extubation. Meanwhile observe the agitation of patients, recovery/wake-up time, extubation time and untoward reactions after the operation, etc..Result:When comparing the three groups:as to the HR and MAP prior to the anesthesia and 1 h after the operation, there were no statistically significant difference among all three groups(p>0.05); as to HR at 5 minutes prior to the extubation, Group C was lower than Group B, with statistical significance (p<0.05); as to the heart rate during extubation, both Group A and Group C were lower than Group B, with statistical significance (P<0.05); as to the blood pressure, Group C is lower than Group B, with statistical significance (P<0.05); as to the heart rate 5 minutes after extubation, Group C is lower than Group B with statistical significance (P<0.05). The heart rate of all three groups increased considerably 5 minutes after the extubation compared with 5 minutes prior to the extubation. The blood pressure in Group B increased considerably 5 minutes after the extubation compared with 5 minutes prior to the extubation, suggesting that, after receiving fentanyl, the patients experienced smaller cyclic variation/fluctuation during recovery/wake-up, or we can say the recovery was smoother. Administer RASS for all three groups. The scores of Group A and Group B were different than that of Group C, with statistical significance (p<0.05), indicating that the prescription of fentanyl 1.5ug/kg and flurbiprofen axetil 1.0mg/kg is effective in preventing post-operation agitation in the cases of gastric and colonic operations. As to the recovery time and extubation time, there were no statistically significant differences among the three groups (p>0.05). This is mainly the result of balanced analgesia. A balanced analgesia is one that combines analgesic medicines of different pharmacological types, with the aim of enhancing analgesic effect and reducing untoward reactions. As for the post-operational untoward reactions, there were no statistically significant differences among the three groups (p>0.05).Conclusion:Injecting Fentanyl 1.5ug/kg and flurbiprofen axetil 1.0mg/kg via veins 20 minutes before the end of the operation is very effective for preventing post-operational agitation in the cases of gastric and colonic operations. It serves to smooth the recovery process without elongating the recovery time and extubation time, producing satisfactory anesthesia result, hence holding encouraging promises for wider clinical application.
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