Effects Of Postoperative Analgesia With Combination Of Sufentanil And Flurbiprofen Axetil On Gastrointestinal Function In Patients Undergoing Lumbar Spondylolisthesis Operation

Objective: To investigate the effects of intravenous application of sufentanil and flurbiprofen axetil on plasma concentration of motilin(MTL)in patients undergoing lumbar spondylolisthesis operation.Methods: Sixty ASA?or?patients aged 35-65 yr weighing 50-80 Kg undergoing lumbar spondylolisthesis operation under general anesthesia were randomly divided into three groups(n=20 each): sufentanil group(S group),flurbiprofen axetil group(K group)and sufentanil + flurbiprofen axetil group(SK group).Analgesic load was given 30 minutes before the end of the operation in each group: S group sufentanil 0.15?g/kg,K group flurbiprofen axetil 1.5mg/kg and SK group sufentanil 0.1?g/kg+ flurbiprofen axetil 1mg/kg,all the experimental drugs were diluted in 10 ml physiological saline,and was pumped in 10 mins at constant speed.PCIA in three groups: S group sufentanil 2.5?g/kg;K group flurbiprofen axetil 3mg/kg;SK group sufentanil 1.5?g/kg+ flurbiprofen axetil 1.5mg/kg.The ramosetron hydrochloride 10?g/kg was also added to each analgesic pump and the analgesic levels(NRS score)of all patients were maintained below 3 points.Recording the NRS pain score and Ramsay sedation score preoperatively(T0),and at the end of the operation(T1),and 6(T2),18(T3),42(T4)hrs after operation.The plasma MTL concentrations at T0,T1,T3 and T4 were measured in each group.The first time of intestinal peristalsis,the flatus time,the defection time and the time of tolerance to solid foods were recorded;The incidence of PONV and other adverse reactions during the PCIA was also compared.Result:There was no significant difference between the three groups in NRS and Ramsay scores at each time points.Compared with T0,the plasma MTL concentrations of all patients were decreased at T1 and T3,the MTL at T4 was decreased in S group,whereas,the MTL at T4 in K group increased significantly(P<0.05).Compared with S group,plasma MTL concentration at T3 and T4 increased significantly(P<0.05),meanwhile,the recovery time of gastrointestinal function were shorted significantly in K group and SK group(P<0.05).The plasma MTL concentrations in the SK group at T3 and T4 were reduced when compared with K group,and the time of tolerance to solid foods in the SK group was significantly shorted(P<0.05).Compared with other two groups,the incidence of nausea and vomiting during the PCIA was significantly decreased in SK group.Conclusion : The perioperative analgesia with the combination of sufentanil and flurbiprofen axetil is beneficial to maintain plasma MTL levels in the physiological range and promote the recovery of gastrointestinal function as soon as possible.