The Clinical Study Of Propofol Combined With Different Dose Of Flurbiprofen Axetil On Analgesia Artifical Abortion

Considering of its Pharmacology, propofol has been commonly used on the patients'anesthesia who will undergo artifical abortion, making patients painless and unconsciousness, however, it has little analgesia effect, the patients will feel lower abdominal pain when they are awake, which will be inhibited by combining with some analgesics during anesthesia. The anesthesiologists often used propofol combined with fentanyl to complete the clinical anesthesia before, which could inhance the analgesia effect, also bring such adverse reactions: respiratory and circulation depression,nause and vomiting,dizziness and headache. Flurbiprofen axetil injection is a newly NSAID with lipid microspheres, which has targeting property, inhibiting COX to decrease the PG's concentration in blood through, so it can alleviate the inflammatory reaction,tissue edema caused by operative trauma, and decrease harmful,painful feeling of distal nerve effectively to abirritate pain. Administering flurbiprofen axetil intravenously has few adverse reactions, no influence on respiratory system, anesthesia deepth and postoperative awaking. The main reason of the lower abdominal pain after operation is that a lot of PG released from the hurt tissues in the uterus which cause the uterus muscle contracting strongly. So combining propofol with NSAIDs on analgesia artifical abortion is an ideal anesthetic proposal now.Objective: To explore the safety and effects, and the ideal single dose of premedication of intravenous anethesia with flurbiprofen axetil during outpatient surgery through comparing the two anesthetic proposals in outpaitent analgesia artifical abortion: using propofol combined with two different dose of flurbiprofen axetil and only propofol itself.Method: Sixty patient (ASAⅠ-Ⅱ), aged 22 to 40 years, weight 40 to 75 kg, gestational period 49 to 60 days, without serious diseases of heart,lung,liver,kidney and blood system, neither were alimentary tract ulcer and allergy, who want to receive analgesia artifical abortion were randomly divided into three groups. All the patients were prohibited food and water for 8 hours , administrated without any premedication,transfusion with NS 10ml/(kg·h) through the vein located on the back of hand,monitoring ECG,BP,RR and SpO2.Group I was administrated with flurbiprofen axetil 1.0mg/kg intravenously first and 10 minutes later followed with 2.0mg/kg propofol intravenously. Group II was administrated with flurbiprofen axetil 1.5mg/kg intravenously first and after 10 minutes, with 2.0mg/kg propofol. Group III was administrated with propofol 2.0mg/kg intravenously. The propofol was administrated after sterilize and the speed of intravenous injection of propofol was 100mg/min in three groups., the operation was started at the eyelash reflex disappeared point. SBP, DBP, HR, RR, SpO2, induction time, recovery time, propofol dosage, the pain of propofol injection, anesthetic effect and postoperative visual analog scale (VAS) of lower abdominal pain in different time (after awaking 1,15,30,45,60min) were recorded.Results:1.changes of respiratory and circulation systems:comparing with the preoperative time, the SBP,DBP,HR and SpO2 during operative time of the patients in groupⅢdropped down obviously (P<0.05); the HR of the patients in groupⅠand groupⅡdropped down slightly. There were more patients appeared pespiratory depression in groupⅢthan that in the other two groups (Ⅲ:Ⅱ:Ⅰ=8:4:4). 2. parameters of anesthesia: There was no significant difference in the three groups in propofol injection induced pain; The propofol dosage and recovery time in group II were the lowest,and the propofol dosage in the group I was lower than that in group III, too (P<0.05); There was no adverse reaction during postanesthesia time in the three groups, there were more patients signed"excellent"of anesthetic effect in group I and II, and the postoperative VAS in group I and II were obviously lower than that in group III (P<0.05), but there was no significant diference between the group I and group II in postoperative VAS.Conclusions:1.Comparing with group III, the other two groups gained better anesthesia effect:the relative stableness of respiratory and circulation systems,the less of propofol dosage and the lower VAS of postoperative lower abdominal pain. 2.Compared within group I and group II, there was no significant statistical difference in anesthesia effect and postoperative VAS, which indicated that we could gain safe and effective anesthesia and postoperative analgesia by administered 1.0mg/kg flurbiprofen axetil 10min ahead of operation. 3. There was no significant difference in the three groups in propofol injection induced pain, and there was no adverse reaction during postanesthesia time in the three groups.