Study on effect of flurbiprofen axetil pretreatment on stress response of oxycodone combined with propofol during painless fiberoptic bronchoscopy
Objective To investigate the effects of flurbiprofen axetil pretreatment on hemodynamics and stress response of oxycodone combined with propofol during painless fiberoptic bronchoscopy.Methods 90 patients with painless fiberoptic bronchoscopy were divided into groups A,B and C by using a prospective study method,with 30 cases in each group.Group A:5 ml of normal saline was injected intravenously 5 min before examination,and 0.1 mg/kg of oxycodone and 2 mg/kg of propofol were injected intravenously before examination.Group B:5 ml of normal saline was injected intravenously 5 min before examination,and 0.08 mg/kg of oxycodone and 2 mg/kg of propofol were injected intravenously before examination.Group C:50 mg of flurbiprofen axetil was given intravenously 5 min before examination,and 0.06 mg/kg of oxycodone and 2 mg/kg of propofol were given intravenously before examination.Three groups were given constant infusion of propofol,and 30-50 mg of propofol was added intravenously if the patients were physically active.Patients in the three groups were compared in terms of hemodynamic indicators[arterial oxygen saturation(SpO2),diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR)]at different time points[5 min before anesthesia induction(T0),immediately after medication(T1),1 min after laryngeal mask placement(T2),1 min after bronchoscopy insertion(T3),1 min after bronchoscopy removal(T4),and 5 min after examination(T5)],stress and inflammatory response indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),epinephrine(E),norepinephrine(NE)]at different time points(T0,3 min after bronchoscope insertion,and T5),and adverse reactions(cough,hypoxemia and laryngeal and bronchospasm).Results At T0,T4 and T5,there was no significant difference in SBP,DBP,HR and SpO2 among the three groups(P>0.05).At T2,there was no significant difference in SpO2 among the three groups(P>0.05).At T1 and T3,there was a statistically significant difference in SpO2 among the three groups(P<0.05).At T1,T2 and T3,there were significant differences in SBP,DBP and HR among the three groups(P<0.05).At T0,there were no significant differences in NE,E,TNF-α and IL-6 among three groups(P>0.05).At 3 min after bronchoscopy insertion and T5,NE,E,TNF-α and IL-6 in group B were higher than those in groups A and C,and the difference was statistically significant(P<0.05).The incidence rates of hypoxemia,cough,laryngeal and bronchospasm in group A were 20.00%,6.67%and 3.33%,those in group B were 3.33%,20.00%and 6.67%,and those in group C were 3.33%,3.33%,3.33%,respectively.Compared with group A,the incidence of hypoxemia in groups B and C was significantly reduced,and the difference was statistically significant(P<0.05).Compared with group B,the incidence of cough in group C was significantly reduced,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of laryngeal and bronchospasm among the three groups(P>0.05).Conclusion Flurbiprofen axetil pretreatment can alleviate the stress response of patients with oxycodone combined with propofol during painless fiberoptic bronchoscopy,and has more stable hemodynamics during the operation,which can reduce the adverse reactions and the dose of anesthetic drugs.
万方数据
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