Abstract:
Objective To observe the influence of dexmedetomidine on the multimodal analgesic effect of flurbiprofen axetil on patients subjected to radical resection of rectal carcinoma.
Methods Ninety patients who underwent abdominal resection of rectal carcinoma were selected and randomly divided into three groups (30 patients in each group). The patients in groups A and B were intravenously injected with flurbiprofen axetil 30 min before operation to achieve preemptive analgesia, while the patients in group C were pretreated with 2 mL lipid emulsion through intravenous injection. Patient-controlled intravenous analgesia pump was prepared as follows: flurbiprofen axetil + dexmedetomidine + sufentanil for group A; flurbiprofen axetil + sufentanil for group B; and sufentanil + 10 mL lipid emulsion for group C. The three groups were added with saline to obtain the final volume of 100 mL. The flow rate of the analgesic pump was 1 mL/h with single press amount of 1 mL and lock time of 15 min. Visual analog scale (VAS) while coughing and Ramsay sedation scores were recorded at 4 h (T1), 8 h (T2), 12 h (T3), 24 h (T4), and 48 h (T5) after operation. The effective press times and dosage of sufentanil were recorded for 24 h after operation, blood glucose level 30 min before and after operation, and C-reactive protein (CRP) 48 h before and after operation were also monitored. The number of patients with enhanced analgesia and adverse reactions, such as nausea and vomiting, dizziness, headache, itchy skin, urinary retention, respiratory depression, and bradycardia, was recorded for 48 h after operation.
Results Ramsay sedation scores of group A at T1 and T2 were higher than those of groups B and C. The VAS scores at T1, T2, and T3 while coughing, effective pumping time of the analgesic pump, post-operational blood glucose level, sufentanil consumption, and CRP of group A were lower than those of groups B and C (P < 0.05). The number of adverse reactions in group A was not significantly different from that in group B. By comparison, this parameter was significantly lower than that in group C (P < 0.05). The enhanced analgesia did not also significantly differ among the three groups.
Conclusion Dexmedetomidine combined with flurbiprofen axetil can induce multimodal analgesia, enhance analgesic effects, and reduce stress and inflammatory responses without the risk of increasing the incidence of adverse reactions.