Abstract: Objective:To observe the influence of preemptive analgesia by nalbuphine combined with flurbiprofen in the platelet activity indexes of the patients with decompensated cirrhosis, and to explore its quality of analgesia in the patients with decompensated cirrhosis. Methods:A total of 120 patients with decompensated cirrhosis were randomly divided into combination group (40 cases, given nalbuphine combined with flurbiprofen before anesthesia), nalbuphine group (40 cases, given nalbuphine before anesthesia) and flurbiprofen group (40 cases, given flurbiprofen before anesthesia). The postoperative patient-controlled intravenous analgesia (PCIA) was carried out with sufentanil in all the patients. The indexes of visual analog score (VAS), PCIA compression number, sufentanil consumption, Ramsay score,thrombelastogram (TEG) indexes (R value, K value, α angle, MA value and CI value) and the maximum aggregation rate by arachidonic acid (MARAA) and β-endorphin (β-EP) level,recovery time, and agitation occurrence rate of the patients in various groups were recorded 12 h and 24 h after operation. Results:The indexes of VAS, PCIA compression number, sufentanil consumption and β-EP level of the patients in combination group were lower than those in the other groups 12 and 24 h after operation (P<0.05), but the differences of the above indexes of the patients in nalbuphine group and flurbiprofen group were not significant (P>0.05). The Ramsay scores of the patients in three groups had no differences at 12 and 24 h after operation (P>0.05). Compared with nalbuphine group, the R values and K values of the patients in combination group and flurbiprofen group at 12 and 24 h after operation were increased (P<0.05), and the α angle, MA values, CI values and MARAA of the patients in combination group and flurbiprofen group were decreased(P<0.05),but the above indexes of the patients in combination group and flurbiprofen group had no significant differences (P>0.05). The recovery time of the patients among three groups had no significant difference (F=2.054, P=0.102). The agitation occurrence rate during recovery period of the patients in case group was the highest (F=5.624, P=0.001), and there was no significant difference in the agitation occurrence rate during recovery period of the patiens between nalbuphine group and flurbiprofen group (χ²=3.020, P=0.091). Conclusion:Combination of nalbuphine and flurbiprofen in the patients with decompensated cirrhosis before analgesia can improve the quality of postoperative analgesia and can't inhibit the activity of platelet obviously.

Key words: decompensated cirrhosis, nalbuphine, flurbiprofen, preemptive analgesia, before analyesia platelet