The Effects Of Patient-controlled Intravenous Analgesia With Flurbiprofen Ester-fentanyl On Analgesic Result And Blood Coagulation After Esophageal Cancer Radical Operation

Objective:To observe the effect of esophageal cancer radical surgery patient-controlled intravenous analgesia with flurbiprofen ester-fentanyl and its effect on blood coagulation, for exploring proper methods of postoperative analgesia.Methods:45 cases of patients with esophageal carcinoma radical surgery were randomly divided into 3 groups (n=15):group I (fentanyl 20μg/kg within PCIA); group II (fentanyl 10μg/kg+flurbiprofen ester 2mg/kg within PCIA); groupⅢ(flurbiprofen ester 1 mg/kg preoperative intravenous pre-emptive analgesia, fentanyl 10μg/kg+flurbiprofen ester 1 mg/kg within PCIA).10 minutes before the end of the surgery inject fentanyl 0.05 mg intravenous, and access to PCIA pump. The PCIA of three groups were joined droperidol 2.5 mg and diluted with saline to 100 ml. Maintenance dose set to 2 ml/h, controlled dose of 0.5 ml, lockout time 5 min. After 1h,24 h,48 h of the surgery the patients observed by visual analogue scale (VAS). Respectively, before surgery 30 min (TO), after 1 h,1d,3 d (T1-3) patients'venous plasma were collected for the test of norepinephrine (NE), adrenocorticotropic hormone (ACTH), cortisol (COS) and platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FB). Results:3 groups postoperative VAS score was no significant difference (P> 0.05). PLT, PT, APTT, FB of 3 groups patients at different points and between the three groups was no significant difference (P> 0.05). After surgery 3 days, the number of PCIA effective self-control groupⅢless than groupⅠ,Ⅱ(P<0.05). At T2, NE level of groupⅢwas lower than groupⅠ,Ⅱ(P<0.05). At T2, groupⅡ,ⅢACTH lower than groupⅠ. At T3, the groupⅢwas lower than groupⅠ(P <0.05). At T1, the groupⅢCOS lower than groupⅠ(P<0.05).Conclusions:Flurbiprofen ester-fentanyl for postoperative esophageal cancer patients with controlled intravenous analgesia, analgesic effect of the exact, little effect on blood coagulation function and reduce opioid doses, and reduce stress levels after surgery is beneficial prognosis of cancer patients.