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Objetive: Flurbiprofen and fentanyl were given 30 minutes before the end of orthopedic hip replacement surgery, which is anesthesiaed by sufentanil and sevoflurane together, to research the differences of the quality of anesthesia recovery period impaced by them.Methods: This research is a randomized controlled study. Sixty ASA I～II patients scheduled for orthopedic hip replacement were selected with the age of 25～60 years and weight of 45～80kg, without electrolyte disturbance, drug abusing history (especially opiums), allergy to any drugs of history of treating with opiums for chronical pain. The patients were randomly divided into three groups (twenty cases in each group, ten cases are men, and the other are women). Group K: 1mg/kg flurbiprofen were injected intravenous slowly at 30 minutes before the end of the surgery; Group F: 1μg/kg fentanyl were injected; Group N: 10ml 0.9% physiological saline were injected. The anesthesia induction and maintenance of the three groups are taking intravenous and inhalation in general anesthesia. Induction doses are as follows: midazolam 0.05mg/kg, vecuronium 0.1mg/kg, etomidate 0.2mg/kg, sufentanil 0.4μg/kg. The anesthesia maintenance is taking sevoflurane inhaled. During surgery, intravenous injection of vecuronium, sufentanil, propofol on-demand and so maintain the depth of anesthesia. Any medication will no longer be given 1hour before the end of surgery. About 7 minutes before the end of surgery turn off N2O, about 3 minutes before the end of surgery turn off sevoflurane, and turn the fresh O2 to 6L/min. After the surgery finished, neostigmine 1mg/kg plus atropine 0.5mg/kg were orders taken to composite residual role of the antagonist nuscle relaxants. To be restored in patients with consciousness, stable spontaneous breathing, and basic restoration of muscle strength, we extubate the tube. Given analgesic drugs in each group 30 minutes before the end of surgery. Record the following items in each group: the mean arterial pressure(MAP) and heart rate(HR) both resting and extubation , eye opening time, extubation time, and directional force recovery time. At the same time, record the pain intensity, sedation score, agitation rate, nausea and vomiting, respiratory depression, sore throat and other adverse reactions.Result:①Three groups of patient’s age and body weight were no statistical difference(p>0.05). Three groups showed no statistical difference between the basic operation(p>0.05).②The MAP and HR of K and F groups’patients with preoperative resting and immediate extubation were no significant difference compared to change the situation(p>0.05), but the mutation rate of MAP and HR in K group was slightly higher than F group. The mutation rate of MAP and HR in N group had a significant difference compared with the other two groups(p<0.05).③Patients in K and N groups with eye opening time, extubation time and directional force recovery time were no statistical difference(p>0.05), but the K group slightly longer. F group eye opening time, extubation time and recovery time of orientation is longer than K and N group, the difference was statistically significant (p<0.05).④Three groups of pain intensity, sedation and agitation rate conditions, N group’s pain and agitation scores were significantly higher than the K and F groups, significantly different (p<0.05), but the sedation score was no significant difference among the three groups(p>0.05). There was no significant difference between K and F groups (p>0.05), but K group was slightly higher than the other.⑤There were 8 patients emerged respiratory depression in F group, K Group 3, N Group 1, it was significantly higher than the K and N groups, there was a significant difference(p<0.05). K and N groups were no significant difference between them(p>0.05). N group had 11 patients experiencing sore throat, K Group 4, F Group 2, N group had higher incidence of sore throat than K and F groups, significantly different(p<0.05). Three groups of patients had no hypotension, bradycardia, and nausea and vomiting.Conclusion: This study suggests that sufentanil sevoflurane orthopedic total hip arthroplasty, flurbiprofen (1mg/kg) and fentanyl (1μg/kg) advanced applicated before the surgery completion can obtain better quality of anesthesia recovery, to postoperative patients’stress, agitation, severe acute pain and acute postoperative sore throat after general anesthesia can play a good preventive effect, provided more surgery analgesic choice for clinical anesthesia, but the analgesic efficacy of flurbiprofen is slightly weaker compared with fentanyl. The advanced application of flurbiprofen in patients’awake time, extubation time and recovery time of orientation has no effect, drowsiness and respiratory depression and other complications had a low incidence, so flurbiprofen can be security applicated in patients.
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