| Flurbiprofen Axetil lipo injection (Kaifen) is a novel nonsteroidal anti-inflammatory drags (NSAIDs), which can depress the postoperative hyperalgesia and facilitate the postoperative recovery by suppressing the Cycloxygenase (COX), restraining the synthesis of prostaglandin (PG), downregulating the release and synthesis of cytokines and inhibitting inflammatory reaction.Part one: Clinical effects of Flurbiprofen axetil on postoperative patient-controlled analgesiaObjective: To observe the clinical effects of Flurbiprofen Axetil lipo injection on postoperative patient-controlled analgesia of modified radical mastectomy patients. To provide a reference for the selection of postoperative analgesia of modified radical mastectomy.Methods: Sixty breast cancer patients (35-60 years old) were choosed and randomly assigned to 2 treatment groups (30 patients per group). The patients in groupâ… received Fentanyl patient controlled intravenous analgesia (PCIA) and the patients in groupâ…¡received fentanyl combined with flurbiprofen axetil PCIA. The resting visual analog scale (VAS) was observed and recorded at 4h, 8h, 12h, 24h and 48h. PCIA was counted by using a PCIA pump.Simultaneously, the incidences of the various untoward reactions, such as nausea, vomiting, respiratory depression and hypersomnia, were analized. Results: 1. There was no statistically significant (P>0.05) between groupâ… and groupâ…¡(The age, height, weight, ASA classification, operation time etc). 2. The visual analogue scale (VAS) was used to evaluate the analgesia. The results showed that both groups achieved satisfactory Analgesia, and there was no statistically significant (P>0.05) between groupâ… and groupâ…¡during 48h of PCIA. 3. The press times of PCIA pump of groupâ… was significantly higher than that of group II (P<0.05). 4. There were no obviously respiratory depression and circulatory depression observed in both groupâ… and groupâ…¡(P>0.05). The results also showed that the incidences of nausea, vomiting and lethargy of groupâ… were significantly higher than that of groupâ…¡(P<0.05).Conclusion: Compared with the application of Fentanyl PCIA alone, the utilization of Fentanyl combined with Flurbiprofen axetil significantly reduced the press times of PCIA pump of modified radical mastectomy patients. Furthermore, the application of Fentanyl combined with Flurbiprofen axetil obtained preferable analgesia and significantly reduced the incidences of nausea, vomiting and lethargy. Therefore, the non-addiction, the strong analgesia, the fever-relieving and the anti-inflammatory made Kaifen, a non-steroidal analgesics used lipid microspheres as vector, more suitable than Fentanyl in the application of analgesia of modified radical mastectomy patientsPart two: The study on IL-6 content and clinical effects of Flurbiprofen Axetil in preemptive analgesiaObjective: To provide the experimental basis for the clinical application of Flurbiprofen Axetil in preemptive analgesia. To provide the reference for the selection of analgesia and analgesic of immunosuppressive and immune disorders patients. In this study, we probed the effects of Flurbiprofen Axetil in preemptive analgesia on interleukin-6 (IL-6) of the modified radical mastectomy breast cancer patients of epidural anesthesia.Methods: Sixty modified radical mastectomy breast cancer patients of epidural anesthesia (50-65 years old) were choosed and randomly assigned to 3 treatment groups (20 patients per group). The patients in groupâ… (control group) received 10 ml saline before epidural anesthesia. The patients in groupâ…¡received 0.75mg/kg Flurbiprofen Axetil intravenously before epidural anesthesia. The patients in groupâ…¢received 0.75mg/kg Flurbiprofen Axetil intravenously before epidural anesthesia. The VAS, the incidences of nausea, vomiting, respiratory depression and lethargy, the quantity of leucocyte and the content of IL-6 were observed and recorded at preanesthesia, 4h postoperation and 12h postoperation, respectively. The expression of IL-6 of peripheral blood was analized by enzyme-linked immunoadsordent assay (ELISA) and polymerase chain reaction (PCR).Results: 1. There was no statistically significant (P>0.05) among groupâ… , groupâ…¡and groupâ…¢(The age, height, weight, ASA classification, operation time etc). 2. The visual analogue scale (VAS) was used to evaluate the analgesia. Compared with groupâ…¡, VAS score of groupâ…¢was significantly lower (P<0.05). Compared with group I, VAS score of groupâ…¡was significantly lower (P<0.05). Furthermore, there was no respiratory depression, cyclic inhibition, nausea and vomiting observed in all three groups. 3. Compared with groupâ… , the amount of leukocyte of groupâ…¡and groupâ…¢was significantly reduced at 4h and 12h postoperation (P<0.05). However, there was no statistically significant (P>0.05) between the amount of leukocyte of groupâ…¡and groupâ…¢. 4. We also analized the expression of IL-6 according to ELISA and RT-PCR method. (1) The ELISA analysis showed that the content of IL-6 of venous blood of group II and groupâ…¢was significantly lower than that of groupâ… (P<0.05) at 4h and 12h postoperation. And, the the content of IL-6 of venous blood of group III was significantly lower than that of groupâ…¡at 4h and 12h postoperation (P<0.05). (2) The RT-PCR analysis showed that, although, in all three groups, the expression of IL-6 of peripheral blood was detected and the elevated expresson of IL-6 was observed from 4h postoperation to 12h postoperation. Compared with groupâ… , the amount of IL-6 of groupâ…¡and groupâ…¢was significantly reduced at 4h and 12h postoperation. And, the amount of IL-6 of groupâ…¢was significantly lower than that of groupâ…¡. In conclusion, Flurbiprofen Axetil downregulated the postoperative expression of IL-6 of peripheral blood, and the downregulation effect of Flurbiprofen Axetil was enhanced accompany with the increase of its doses.Conclusion:â‘ The application of Flurbiprofen Axetil in preemptive analgesia significantly reduced the content of IL-6 of modified radical mastectomy breast cancer patients and facilitated recovery by suppressing intraoperative and postoperative inflammatory reaction.â‘¡The application of Flurbiprofen Axetil in epidural anesthesia gained satisfied clinical results. Flurbiprofen Axetil could restrain the postoperative inflammatory reaction and promote the healing of the patients, especially gerontal patients. Furthermore, Flurbiprofen Axetil possessed satisfactory immunoloregulation effects but side effects, such as respiratory depression, of opioids. Our study provided the theoretical and the experimental basis for the application of Flurbiprofen Axetil in preemptive analgesia. |
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