摘要
目的探讨术前应用加巴喷丁对瑞芬太尼致术后痛觉过敏的影响。方法 60例择期妇科腹腔镜患者,ASA分级I~II级,年龄20~40岁,随机分为两组,每组30例:加巴喷丁组(G组)和对照组(C组)。G组在术前2 h口服加巴喷丁1 200 mg,C组术前2 h口服安慰剂。两组患者术中麻醉均靶控静脉泵注异丙酚和瑞芬太尼,并间断静脉注射顺阿曲库铵维持肌松。分别记录两组的麻醉时间、手术时间、恢复室观察时间;苏醒时间、意识恢复时间和拔管时间;术中的平均BIS值;Ramsay镇静评分;患者意识恢复时的视觉模拟评分(VAS);术中麻醉药物用量。两组术后均进行芬太尼静脉术后镇痛(PCIA),镇痛泵背景剂量均设置为空白,分别记录术后PCA泵中芬太尼用量,并记录术后并发症。结果①两组患者术中静脉麻醉药物用量(丙泊酚、瑞芬太尼)、苏醒时间、意识恢复时间、拔管时间比较均无明显差异(p>0.05);②G组的Ramsay镇静评分比C组明显降低(p<0.05),意识恢复时VAS评分比C组明显降低(p<0.05);③G组患者术后24 h内各时间点的PCA泵芬太尼用量比C组显著减少(p<0.05);④两组术后24 h的头痛、恶心、呕吐、寒战、瘙痒的发生率比较均无明显差异(p<0.05);G组躁动发生率比C组显著降低(p<0.05),但头晕发生率比C组显著增高(p<0.05)。结论术前应用加巴喷丁可有效抑制瑞芬太尼所致的术后痛觉过敏。
Objective To explore the effects of gapapentin on remifentanil-induced postoperative hyperalgesia after gynecological laparoscopy. Methods Sixty patients scheduled for laparoscopic cholecystectomy were randomly allocated to receive: ① Gapapentin 1 200 mg as premedication and intraoperative target-controlled infusion of remifentanil(Group P);②a placebo as premedication and intraoperative target-controlled infusion of remifentanil(Group C).Postoperative pain was controlled by Patient-controlled analgesia(PCA) with fentanyl.The patients were evaluated by using Visual analogue scale(VAS) for pain scores when they had recovered.The consumption of fentanyl,sedation score,and side effects were also observed. Results ①There were no significant difference in the consumption of propofol,remifentanil,emergence time,consciousness recovery time and extubation time(p0.05).②Conpared with group C,the Ramsay sedation score,VAS of recovered time were significantly decreased in group P(p0.05);③The fentanyl consumption in PCA were significantly at 1 h,2 h,4 h,8 h,12 h,24 h after operation in group P were less than those in group C(p0.05);④The incidence of dizziness in group P was higher than group C(p0.05),while the incidence of dysphoria was lower than group C(p0.05). Conclusion Pretreatment with gapapentin can reduce remifentyl-induced postoperative hyperalgesia.
出处
《现代医院》
2011年第10期3-5,共3页
Modern Hospitals
基金
广东省医学科研课题(编号:B2011104)
广东省科技计划资助项目(编号:2011B031800058)
关键词
加巴喷丁
瑞芬太尼
术后痛觉过敏
Gapapentin
Remifentanil
Gynecological laparoscopy
Postoperative hyperalgesia