不同药物在减轻瑞芬太尼麻醉后痛觉的应用研究

Application Research of Different Drugs in Reducing Post-anesthetic Hyperalgesia Induced by Remifentanil

目的:分别观察使用小剂量氯胺酮、曲马多、布托啡诺减轻瑞芬太尼麻醉后痛觉过敏的药物效果研究。方法:选取上腹部手术患者80例,ASA I～II级,随机分为四组(A、B、C、D),四组均采用静吸复合全身麻醉,A组手术结束前静脉注射氯胺酮0.5mg/kg、B组手术结束前静脉注射曲马多1.5mg/kg、C组手术结束前注射布托啡诺0.01mg/kg、D组(对照组)不注射任何药物。分别记录各组苏醒时间、拔管时患者血流动力学指标、苏醒后VAS评分及距离拔管再次要求镇痛的时间。结果:四组患者苏醒时间及拔管是血流动力学指标在统计学上无显著性差异;苏醒后VAS评分D组显著高于其它三组,具有统计学差异。结论:由试验结果可以得到小剂量氯胺酮、曲马多、布托啡诺均可以减轻瑞芬太尼麻醉后痛觉过敏,其中氯胺酮的产生效果要高于曲马多及布托啡诺。

Objective：Hyperalgesia were observed in the use of small doses of ketamine,tramadol,butorphanol reduce remifentanil drug effect studies.Methods： 80 cases of upper abdominal surgery patients,ASA physical status I Level II,were randomly divided into four groups（A,B,C,D）,four groups are used isoflurane general anesthesia,group A the end of surgery before the intravenous injection of ketamine 0.5 mg / kg,and group B the end of surgery before intravenous injection tramadol 1.5mg/kg,group C of the end of surgery before the injection of butorphanol promise 0.01mg/kg,group D（control group） were not injected with any drug.Were recorded in each group emergence time,extubation in patients with hemodynamic parameters,VAS score and from the extubation again require analgesic time after waking up.Results：Four patients wake up time and extubation hemodynamics was no statistically significant difference;regained consciousness after the VAS score in group D was significantly higher than the other three groups,with a significant difference.Conclusion：The results can be a small dose of ketamine,tramadol,butorphanol can reduce hyperalgesia after remifentanil,ketamine effect is higher than that of tramadol and butorphanol.