Flurbiprofen Used In One-lung Ventilation Improves Intraoperative Regional Cerebral Oxygen Saturation And Reduces The Incidence Of Postoperative Delirium

Objective:We previously demonstrated that flurbiprofen increased arterial oxygen partial pressure and reduced intrapulmonary shunt.The present study aims to investigate whether flurbiprofen improves intraoperative regional cerebral oxygen saturation（rScO₂）and reduces the incidence of postoperative delirium（POD）in elderly patients undergoing one-lung ventilation（OLV）.Methods:One hundred and twenty patients undergoing thoracoscopic lobectomy were randomly assigned to the flurbiprofen-treated group（n=60）and the control-treated group（n=60）.Flurbiprofen（100mg）was intravenously administered 20 minutes before skin incision.To record the general conditions of patients in both groups,including age,sex,ASA grade,year of education,MMSE score,hemoglobin,baseline mean blood pressure,baseline heart rate,duration of anesthesia,duration of surgery,duration of OLV,phenylephrine and blood loss,urine output,fluid infusion during the surgery,chest tube removal time,lung infection rate,visual analog scale score,or ICU stay.With the whole rScO2 data of each subject,the baseline,mean and minimum absolute rScO2 values of both sides during surgery were recorded,calculated and sifted.The partial pressure of arterial oxygen（PaO₂）and Partial pressure of carbon dioxide（PCO₂）were recorded during before anesthesia,15min after double-lung ventilation（supine position）,15,30,and 60min after OLV,and 30min after reexpansion of the collapsed lung,and POD was measured by the Confusion Assessment Method（CAM）within five days after surgery.Results:There were no significant differences in general information between the two groups,including gender,age,BMI,ASA grade,year of education,MMSE score,hemoglobin（P>0.05）.Compared with the control group,treatment with flurbiprofen significantly improved the mean value of intraoperative rScO₂as well as the baseline values of the rScO₂area under threshold（AUT）（P<0.05,both）and significantly reduced the PaO₂value and Qs/Qt value（P<0.01）at 15 minutes,30 minutes and 60minutes after OLV in the flurbiprofen-treated group.After surgery,the POD incidence in the flurbiprofen-treated group was significantly decreased compared with that in the control group（P<0.05）.Conclusion:Treatment with flurbiprofen may improves rScO₂and reduces the incidence of POD in elderly patients undergoing thoracoscopic one-lung ventilation surgery for lung cancer.