Non-steroidal anti-inflammatory drugs reduce the stress response during sevoflurane anesthesia.
BACKGROUND
Non-steroidal anti-inflammatory drugs are analgesics commonly used for post-operative pain. However, their effect on dosages of inhaled anesthetics during surgery is unclear. We investigated the effect of flurbiprofen axetil and parecoxib sodium on the minimum alveolar concentration of sevoflurane required to blunt stress responses to skin incision under general anesthesia.


METHODS
One hundred and five adult patients were randomly allocated to four treatment groups, each receiving sevoflurane: control (sevoflurane only), lidocaine (1 mg/kg bolus, followed by continuous infusion of 20 μg/kg/min after intubation), Intravenous (IV) flurbiprofen (1 mg/kg before skin incision), and IV parecoxib (40 mg before skin incision). Following anesthetic induction and stabilization of end-tidal sevoflurane concentration, mean arterial blood pressure and heart rate were recorded 2 min before and at 5-min intervals after skin incision. The stable end-tidal sevoflurane concentration was calculated using an up-and-down method.


RESULTS
The minimum alveolar concentration of sevoflurane required to blunt the stress responses to skin incision in the control, lidocaine, flurbiprofen, and parecoxib groups was 4.63 ± 0.08%, 2.67 ± 0.08%, 3.33 ± 0.08%, and 3.80 ± 0.11%, respectively. These figures for the later three groups were all significantly less than that of the control group (P = 0.021, P = 0.037, and P = 0.011, respectively); that of the flurbiprofen group was significantly less than the parecoxib (P = 0.034).


CONCLUSIONS
The non-steroidal anti-inflammatory drugs flurbiprofen axetil and parecoxib sodium decreased the minimum alveolar concentration of sevoflurane required to blunt the stress response to skin incision during general anesthesia.
Department of Anesthesiology, First Affiliated Hospital of China Medical University, Shenyang, China.
Z
Z
Liu
H
H
Lu
G
G
He
H
H
Ma
J
J
Wang
D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005480:Flurbiprofen / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D007555:Isoxazoles / Q000494:pharmacology / Q000627:therapeutic use*; D008012:Lidocaine / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D008875:Middle Aged; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000378:metabolism; D000077149:Sevoflurane; D012867:Skin / Q000293:injuries; D026941:Sodium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D055815:Young Adult
D018685:Anesthetics, Inhalation; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; D008738:Methyl Ethers; D026941:Sodium Channel Blockers; D000077149:Sevoflurane; D005480:Flurbiprofen; D008012:Lidocaine; C409945:parecoxib; C504422:flurbiprofen axetil