摘要
目的探讨术中输注右美托咪定对瑞芬太尼诱发痛觉过敏的影响。方法择期腹腔镜胆囊切除术联合胆道探查术患者50例,随机分为两组,麻醉诱导后分别持续输注右美托咪定0.5μg·kg-1·h-1(D组)或等量生理盐水(C组)。两组患者均输注瑞芬太尼0.3μg·kg-1·min-1并吸入七氟醚维持麻醉,BIS值维持在40~60。术毕所有患者均行芬太尼PCIA,并在PACU观察2h。记录患者术后24、48hVAS评分及镇痛泵按压次数和芬太尼用量。结果与C组比较,D组患者入PACU后第一次VAS≥4分的VAS评分明显减小(P<0.05),VAS<4分时间明显缩短(P<0.01),PACU时PCIA用量明显减少(P<0.05),术后24、48h内PCIA泵按压次数明显减少(P<0.01)。结论术中静注右美托咪定能有效缓解术后疼痛,减少术后镇痛药用量,并能够减轻瑞芬太尼所致痛觉过敏,且不影响患者麻醉苏醒质量。
Objective To investigate the influence of intraoperative dexmedetomidine on remifentanil-induced postoperative hyperalgesia. Methods Fifty patients scheduled for laparoscopic cholecystectomy and biliary passage exploration were randomly divided into two groups. After induction of anesthesia, patients in the group D were given dexmedetomidine via vein at 0. 5 μg·kg-1·h-1 , patients in the group C were given same volume saline. Both groups were given intravenous infusion of 0. 3 μg·kg-1 min-1 remifentanil and inhaled sevoflurane to maintain anesthesia and keep the BIS from 40 to 60. The patients were placed in PACU for 2 h after operation and then patient- controlled intravenous analgesia (PCIA) was used. The following events were recorded: the VAS score of pain when in PACU for 15 min, the time from the administration of PCIA to VAS%4, the total amount of PCIA consumed in PACU, the VAS pain scores at 24 h and 48 h postoperatively. Results Compared with the group C, the average MAC during the surgery decreased significantly in the group D (P〈0.05), and the VAS score of pain when in PACU for 15 min was significantly lower (P〈0. 05), the time to VAS of pain%4 was shorter (P〈0. 01), the times of PCIA usage was decreased by 24 h and 48 h (P〈0. 01). Conclusion Intraoperative dexmedetomidine can effectively relieve postoperative pain, reduce postoperative analgesic requirements and alleviate remifentanil- induced hyperalgesia without affecting the anesthesia revival.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第4期356-358,共3页
Journal of Clinical Anesthesiology