Effect Of Dexmedetomidine Combined With Preoperative Intravenous Flurbiprofen Axetil On Agitation In Patients Undergoing Lumbar Disc Herniation Surgery Under General Anesthesia

Objective:This study aimed to test the efficiency of dexmedetomidine combined with preoperative intravenous flurbiprofen axetil preventing emergence agitation and reducing extubation reaction in patients undergoing lumbar disc herniation surgery after general anesthesia.Methods:Select 80 patients needed lumbar disc herniation surgery from February2015-August 2015 to enroll in the study,ASA I or II,aged 35-65,and the operations were finished by same doctors.80 patients were divided into four groups with 20 patients in each group according to to the random number grouping method,Dexmedetomidine(group D)、Flurbiprofen(group F)、normal saline(group C)、Dexmedetomidine plus flurbiprofen(group DF).80 cases of patients connected the monitor for monitoring of vital signs and underwent invasive arterial monitoring and central venous pressure.Four groups were given tracheal intubation general anesthesia.All the patients intravenously received dexmedetomidine 0.8ug/kg in10 min before introduce.Give sufentanyl,propofol,cisatracurium esmolol for anethesia induction,then pump propofol,cisatracuium to maintain depth of anesthesia.In group F,patients intravenously received dexmedetomidine 0.5ug/kg before the end of oepration;In group F,patients intravenously received flurbiprofen 50 mg when induction;In group C,an equivalent amount of saline was administered in a similar manner;In group DF,patients intravenously received flurbiprofen 50 mg and dexmedetomidine 0.25ug/kg when induction and 15 min before the end of operation,respectively.Extubation time,Ramsay sedation score 5min after extubation,Agitation score before extubation,Numbers of nausea and vomiting,increase of glucose were observed;HR 、 MAP were recorded before extubation(T1),extubation(T2),5min after extubation(T3),10 min after extubation(T4).Results:(1)The general composition,average age,weight,operation time,grade of ASA had no significant difference between four groups,P>0.05.(2)The extubation time,Ramsay scores in groups D were significantly longer or higher than those in group C,group F and group DF,P<0.05.The agitation scores in group D and group DF were significantly lower than those in group C,P<0.05.(3)The increase values of glucose in group D、 group F and group DF were significantly lower than group C,P<0.01.(4)Compared with T1,HR、MAP at T2,T3,T4 in group F and group C were significantly increased,P<0.05 or P<0.01;HR、MAP at T2,T3,T4 in group D and group DF were significantly lower than those in group C,P<0.01.Conclusion:Preoperative flurbiprofen axetil 50 mg plus dexmedetomidine 0.25ug/kg 15 min before the end of operation has the advantage of reducing extubation cardiovascular reaction and emergence agitation during recovery period,without prolonging the extubation and recovery time,so the clinical application is safe and has important clinical value.