Flurbiprofen used in one-lung ventilation improves intraoperative regional cerebral oxygen saturation and reduces the incidence of postoperative delirium

Liang Shen; Jia-Qi Chen; Xin-Lu Yang; Ji-Cheng Hu; Wei Gao; Xiao-Qing Chai; Di Wang

doi:10.3389/fpsyt.2022.889637

Flurbiprofen used in one-lung ventilation improves intraoperative regional cerebral oxygen saturation and reduces the incidence of postoperative delirium

Front Psychiatry. 2022 Aug 31:13:889637. doi: 10.3389/fpsyt.2022.889637. eCollection 2022.

Authors

Liang Shen^{1

2}, Jia-Qi Chen², Xin-Lu Yang², Ji-Cheng Hu², Wei Gao², Xiao-Qing Chai², Di Wang^{1

2}

Affiliations

¹ Department of Anesthesiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
² Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China.

Abstract

Background: We previously demonstrated that flurbiprofen increased arterial oxygen partial pressure and reduced intrapulmonary shunts. The present study aims to investigate whether flurbiprofen improves intraoperative regional cerebral oxygen saturation (rScO₂) and reduces the incidence of postoperative delirium (POD) in elderly patients undergoing one-lung ventilation (OLV).

Methods: One hundred and twenty patients undergoing thoracoscopic lobectomy were randomly assigned to the flurbiprofen-treated group (n = 60) and the control-treated group (n = 60). Flurbiprofen was intravenously administered 20 minutes before skin incision. The rScO₂ and partial pressure of arterial oxygen (PaO₂) were recorded during the surgery, and POD was measured by the Confusion Assessment Method (CAM) within 5 days after surgery. The study was registered in the Chinese Clinical Trial Registry with the number ChiCTR1800020032.

Results: Compared with the control group, treatment with flurbiprofen significantly improved the mean value of intraoperative rScO₂ as well as the PaO₂ value (P < 0.05, both) and significantly reduced the baseline values of the rScO₂ area under threshold (AUT) (P < 0.01) at 15, 30, and 60 min after OLV in the flurbiprofen-treated group. After surgery, the POD incidence in the flurbiprofen-treated group was significantly decreased compared with that in the control group (P < 0.05).

Conclusion: Treatment with flurbiprofen may improve rScO₂ and reduce the incidence of POD in elderly patients undergoing thoracoscopic one-lung ventilation surgery for lung cancer.

Clinical trial registration: http://www.chictr.org/cn/, identifier ChiCTR1800020032.

Keywords: flurbiprofen; one-lung ventilation; postoperative delirium; regional cerebral oxygen saturation; thoracic surgery.