Effects of flurbiprofen axetil administered at different time points on oxygenation in patients undergoing one-lung ventilation

Abstract

Objective To evaluate the effects of flurbiprofen axetil administered at different time points on oxygenation in the patients undergoing one-lung ventilation(OLV). Methods Ninety patients of both sexes, aged 45-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective thoracoscope-assisted pulmonary lobectomy, were assigned into 3 groups(n=30 each)using a random number table: control group(group C), preoperative administration group(group F1)and intraoperative administration group(group F2). Flurbiprofen axetil (10 mg/ml) and fat emulsion 10 ml were injected intravenously at 15 min before operation in F1 and C groups, respectively.Flurbiprofen axetil 10 ml was intravenously injected immediately after the beginning of OLV in group F2.At 15 min before operation(T1), 15 and 30 min of OLV(T2, 3), and 15 min after restoration of two-lung ventilation(T4), airway peak pressure(Ppeak)and dynamic lung compliance(Cdyn)were recorded, arterial blood samples were collected for blood gas analysis.The arterial oxygen partial pressure(PaO2)was recorded, and the oxygenation index(OI)and intrapulmonary shunt(Qs/Qt)were calculated.The concentrations of thromboxane B2(TXB2)and 6-keto-prostaglandin F1α(6-K-PGF1α)in serum were measured by enzyme-linked immunosorbent assay, and TXB2/6-K-PGF1α ratio was calculated.The development of interrupting OLV due to SpO2<90% and postoperative dyspnea, pulmonary infection, atelectasis and length of hospital stay were recorded. Results Compared with group C, PaO2 and OI were significantly increased, and Qs/Qt was decreased at T2, 3, the serum concentrations of TXB2 and 6-K-PGF1α were decreased, and TXB2/6-K-PGF1α ratio was increased at T2-4, the incidence of interrupting OLV was decreased(P 0.05). Compared with group F1, PaO2 and OI were significantly decreased at T2, 3, Qs/Qt was increased at T2, and the serum concentrations of TXB2 and 6-K-PGF1α were increased, and TXB2/6-K-PGF1α ratio was decreased at T2-4 in group F2(P 0.05). Conclusion Flurbiprofen axetil injected at 15 min before operation can significantly improve oxygenation and prevent the development of hyoxemia in the patients undergoing OLV, however, flurbiprofen axetil administered immediately after the beginning of OLV has no such effect. Key words: Flurbiprofen; Pulmonary gas exchange; Respiration, artificial