Effects of Dexmedetomidine Combined with Flurbiprofen Axetil on Stress Factors and Blood Glucose in Severe Burn Patients during General Anesthesia Recovery Period
HUAI Qiao, YANG Yan-chao, GUO Hui-yi,et al
Department of Anesthesiology, the First Hospital of Shijiazhuang, 050011, Shijiazhuang
Abstract：【Objective】 To investigate the effects of dexmedetomidine combined with flurbiprofen axetil on stress factors and blood glucose in severe burn patients during general anesthesia recovery period. 【Methods】 A total of 80 cases of severe burn patients from June 2015 to January 2017 in our hospital were selected as the research subjects. According to the random number method, patients were divided into the dexmedetomidine group (DEX), flurbiprofen group ( FLU), dexmedetomidine combined flurbiprofen group (DEX + FLU), and the control group (C group). 30 min before the end of surgery, patients in the DEX group received an intravenous injection of dexmedetomidine (0.25 g/kg); the FLU group received an intravenous injection of flurbiprofen (50 mg); theDEX+FLU group received an intravenous injection of both dexmedetomidine (0.25 g/kg) and flurbiprofen (50 mg); and group C received the same amount volume as group DEX by intravenous injection. The levels of plasma epinephrine (E), norepinephrine (NE), cortisol (COR), and blood glucose (GLU) of all four groups were recorded before the induction of anesthesia (T 0), 15min before extubation (T 1), immediately after extubation (T 2), and 15min after extubation (T 3). Patients' recovery time, extubation time and incidence of restlessness during recovery were monitored as well. 【Results】Compared with T0, the levels of plasma E,NE ,COR, and GLU of the C, DEX, and FLU groups during T 1 to T 3 , were significantly higher; the difference was statistically significant (P＜0.05). Compared with group Cplasma E, NE, COR and GLU levels were significantly reduced in group DEX, FLU and DEX+FLU from T 1 ~T 3 ; and DEX+FLU group decreased the most (P＜0.05). The incidence of agitation in the DEX group and DEX+FLU group was significantly lower than that of C group; the difference was statistically significant (P＜0.05). The incidence of agitation in the FLU group was lower than that in the C group, but there was no significant difference (P＞0.05). 【Conclusion】 Dexmedetomidine combined with flurbiprofen can significantly reduce stress response and blood glucose levels in patients with severe burn during recovery period of general anesthesia and reduce the incidence of emergence agitationwithout prolonging the recovery time and extubation time.
怀乔,杨艳超,郭会艺,蒋晨霞,孟香果,孙瑞朋. 右美托咪定复合氟比洛芬酯对重度烧伤患者全身麻醉苏醒期应激因子及血糖的影响[J]. 医学临床研究, 2017, 34(7): 1307-1310,1312.
HUAI Qiao, YANG Yan-chao, GUO Hui-yi,et al. Effects of Dexmedetomidine Combined with Flurbiprofen Axetil on Stress Factors and Blood Glucose in Severe Burn Patients during General Anesthesia Recovery Period. JOURNAL OF CLINICAL RESEARCH, 2017, 34(7): 1307-1310,1312.
[1] 郝雪莲,王莉,孙媛,等.右美托咪定复合七氟烷麻醉对儿童烧伤短小手术麻醉苏醒期躁动及血流动力学影响分析[J].中国医学前沿杂志(电子版),2016,8(6):129-132. [2] Abdullahi A, Chen P, Stanojcic M,et al. IL-6 signal from the bone marrow is required for the browning of white adipose tissue post burn injury[J]. Shock, 2017, 47(1):33. [3] 哈宏伟.基于应激系统理论的护理对重度烧伤患者创伤后成长的干预效果[D].河北联合大学,2015 [4] Lin H.Use of dexmedetomidine for sedation in critically ill mechanically ventilated pediatric burn patients.[J]. J Burn Care Res, 2008,32(1):98-103. [5] 汪更胜.镇静治疗对危重烧伤患者炎症因子释放的影响[J].医学临床研究,2014,31(9):1716-1718. [6] 龚小花,吴文俊,陈雄等.糖尿病对烧伤创面氧化应激状态的影响[J].温州医科大学学报,2016,46(8):597-599. [7] 张放,邱啸臣,朱世辉,等.烧伤后的氧化应激损伤及治疗策略[J].中华医学杂志,2012,92(42):3017-3019. [8] 贾晓鹏,马盼盼,顾世召等.右美托咪定复合异丙酚和瑞芬太尼在重度烧伤患者围手术期麻醉中的应用[J].中华烧伤杂志,2016,32(11):692-694. [9] 徐文,谭小云.右美托咪定复合氟比洛芬酯对烧伤患者全身麻醉苏醒期躁动及血液动力学的影响[J].中国现代医学杂志,2015,25(30):86-88. [10] 曹进勇,徐庆连.烧伤合并应激性高血糖研究进展[J].安徽医学,2014,(6):850-853. [11] 王大龙,张海山,郑观荣,等.右美托咪定对大面积烧伤患者静脉全身麻醉切痂植皮术应激反应的影响[J].中国现代医学杂志,2014,24(20):73-76. [12] 褚万立,柴家科.严重烧伤后应激性高血糖及胰岛素强化治疗进展[J].中华损伤与修复杂志(电子版),2012,07(2):73-76. [13] 吴道义,黄文祥,陈炯等.不同复苏方案对猪烧伤休克期组织氧代谢的影响[J].中华医学杂志,2016,96(12):975-978. [14] 陈明华,张铨,胡贵,等.右美托咪定复合氯胺酮与单纯氯胺酮在患儿烧伤换药镇静中的比较[J].临床麻醉学杂志,2012,28(11):1055-1057. [15] 武永生,刘英飞,苏心镜,等.氟比洛芬酯超前镇痛用于预防烧伤创面换药操作痛的临床效果观察[J].河北医药,2015,37(18):2825-2826.
2017, Vol. 34 
