瑞芬太尼诱发老年患者急性阿片类耐受的临床研究

Development of acute opioid tolerance after infusion of remifentanil for elder

目的通过术中持续输注不同剂量瑞芬太尼,观察其是否诱发老年患者术后急性阿片类药物的耐受。方法50例老年患者,术中分别持续输注瑞芬太尼0.3μg/(kg·min)(H组)和0.1μg/(kg·min)(L组)。记录术后麻醉恢复室芬太尼用量、术后24h的芬太尼累积用量。结果H组术后麻醉恢复室芬太尼用量、术后24h的芬太尼累积用量显著高于L组。结论术中持续输注大剂量瑞芬太尼可诱发老年患者术后急性阿片耐受。

Objective To observe the development of acute opioid tolerance after intraoperative remifentanil infusion for elder undergoing major abdominal surgery. Methods Fifty elder patients were random- ly assigned to infusion 0.3 μg/（kg·min） in high-dose group and 0. 1 μg/（kg·min） of remifentanil low-dose group. After the operation, the fentanil consumption in the postanesthetic care unit, the cumulative postoperative fentanil consumption in 24 h, were recorded. Results The fentanil consumption in the postanesthetic care unit, the cumulative postoperative fentanil consumption in 24 h were significantly more than those in low-dose group at each time point in the initial 24 h after surgery. Conclusion Acute opioid tolerance is developed after intraop-erative remifentanil infusion for elder