瑞芬太尼诱发术后痛觉过敏的机制及防治进展

Research progress on remifentanil-induced hyperalgesia and its prevention and treatment

瑞芬太尼在临床实践中的应用具有诸多优点,从日间手术麻醉到更复杂的大型手术均广泛应用瑞芬太尼。尽管如此,瑞芬太尼一直与阿片诱导的痛觉过敏(opioid-induced hyperalgesia,OIH)的发生有关,OIH的发生可能会导致延迟术后的恢复和患者的及时出院等问题。此外,它会导致患者的不适与较高的疼痛评分,增加镇痛药物的用量,以及由此带来的其他相关不良反应。瑞芬太尼是最易发生痛觉过敏的阿片类药物,因此本文对瑞芬太尼诱导的痛觉过敏(remifentanil-inducedhyperalgesia,RIH)进行综述,描述相关的发生机制和预防措施旨在降低发病率。

Remifentanil has several advantages in clinical practice, ranging from daytime anesthesia to more complex large- scale surgery. Nevertheless, remifentanil has been associated with opioid-induced hyperalgesia (OIH). The development of OIH may lead to some problems, delaying the recovery after surgery and prompt discharge of patients. In addition, it can lead to discomfort and higher pain scores, more use of analgesics, and related side effects. Remifentanil is the most susceptible opioid drug to hyperalgesia. Therefore, we review the mechanism and preventive measures of remifentanil-induced hyperalgesia (RIH) to reduce the incidence of hyperalgesia.