Intravenous flurbiprofen axetil can stabilize the hemodynamic instability due to mesenteric traction syndrome--evaluation with continuous measurement of the systemic vascular resistance index using a FloTrac® sensor

Abstract

Objective: Evaluation of the stabilizing effect of intravenous flurbiprofen axetil against hemodynamic instability due to mesenteric traction syndrome (MTS) by continuous measurement of systemic vascular resistance index (SVRI) using a FloTrac(®) sensor was evaluated.

Design: Prospective randomized trial.

Setting: A single-center study performed in an educational hospital.

Participants: Two prospective studies were carried out, each with 40 patients scheduled for elective open abdominal surgery.

Intervention: Twenty patients received 50 mg of flurbiprofen axetil after the recognition of MTS by the anesthesiologist (group FT). The remaining patients served as controls (groups CP and CT).

Measurements and main results: SVRI data was collected every 20 seconds for 1 hour after starting the laparotomy. The average SVRI prior to skin incision was taken as the baseline. Following 3 values were devised to evaluate MTS: the S-value (sum total of changes in SVRI from baseline), the T-value (period during which SVRI remained 20% or more below baseline), and the M-value (maximum change in SVRI from baseline). In group FP, decrease in SVRI was smaller than in group CP, and statistical differences in the 3 values were found. In group FT, SVRI recovered earlier than in group CT, and statistical differences were found in S-value and T-value. However, the M-value had no statistical differences.

Conclusions: Intravenous flurbiprofen axetil can stabilize the hemodynamic instability due to MTS.

Keywords: cardiac output; flurbiprofen axetil; mesenteric traction syndrome; preventive effect; systemic vascular resistance index; therapeutic effect.