Effect Of Nonsteroidal Antiinflammatory Drugs On The MAC_BAR Of Sevoflurane In Propofol-remifentanil General Anesthesia.

Nonsteroidal antiinflammatory drugs(NSAIDs) are commonly used analgesics for the treatment of postoperative pain and affected the doses of opioids, but its effect on inhaled anesthetics during general anesthesia is not known. Therefore, we designed this study to evaluate the effect of NSAIDs, flurbiprofen axetil and praecoxib sodium on the MACBAR (The minimum alveolar concentration which block the adrenergic response to a noxious stimulus) of sevoflurane for skin incision during general anesthesia and compared with local anesthtic, lidocaine, known could decrease MAC.Materials and MethodsEighty ASAⅠ-Ⅱpatients aged 20-50 years undergoing the elective otic or thyroid gland operation were enrolled in this study, BMI18-25kg/m2.The patients were randomly divided into four groups:Group So received sevoflurane alone,Group S1 received sevofloure and lidocaine,with a bolus of lidocaine 1mg/kg,followed by an continual infusion of 20ug-kg-1after intubtion,Group S2 and S3 received sevofloure plus flurbiprofen lmg-kg-1 and parecoxib sodium 40mg respectively before skin incision.Anesthesia induction was with intravenous propofol (2mg/kg),cisatracurium besilate (0.15mg/kg),remifentanil hydrochloride (1ug/kg).Mean arterial blood pressure(MAP) and heart rate(HR) at baseline,2 min,l min before skin incision,every minute of five minute after skin incision were recorded.According to the concentraon of sevoflurane after reaching the equilibrium point,the stable end-tidal sevoflurane of each groups by using the"up and down"method was calculated MACBAR. ResultsThere were no differences in the demographic data among the four groups.The MACBAR of sevoflurane were 4.63±0.08%,2.67±0.08%,3.33±0.08%,3.80±0.11% in So group,S1 group,S2 group,S3 group,respectively.MACBAR of sevoflurane in S1 group,S2 group,S3 group were decease significant,as compared with So group (P< 0.05).There are significant difference between the S2 group and S3 group(P< 0.05).ConclusionNonsteroidal antiinflammatory drugs could decrease the MACBAR of sevoflurane, Flurbiprofen axetil was stronger than parecoxib sodium,but weaker than lidocaine.