喷他佐辛对瑞芬太尼麻醉后痛觉过敏的影响

目的 观察喷他佐辛对预防瑞芬太尼麻醉后痛觉过敏的影响.方法 选择择期行腹腔镜胆囊切除术病人60例(ASA Ⅰ～Ⅱ 级),随机分为2组,各组均采取气管内插管全凭静脉麻醉,术中以静脉泵注丙泊酚以及瑞芬太尼维持麻醉,间断给予维库溴铵维持肌松.P组(n=30):手术结束前10min静脉滴注喷他佐辛0.5 mg/kg;F组(n=30):手术结束前10 min静脉滴注芬太尼1 μg/kg.记录2组病人自主呼吸恢复时间、呼之睁眼时间、气管导管拔除时间、拔管后5 min、10 min VRS评分以及术后24h有无恶心呕吐、呼吸抑制及术后躁动情况.结果 2组患者拔管后VRS评分差异无显著性(P>0.05),自主呼吸恢复时间、呼之睁眼时间、气管导管拔除时间P组明显短于F组 (P<0.05),术后24 h内2组均无呼吸抑制、恶心呕吐和躁动.结论喷他佐辛0.5 mg/kg静脉滴注可有效减轻瑞芬太尼全麻后急性痛觉过敏.

Effect of pentazocine on postoperative hyperalgesia after remifentanlbased anesthesia

Objective: To observe the effect of pentazocine on preventing postoperative hyperalgesia induced by remifentanil based anesthesia.Methods: Sixty cases of Laparoscopic Cholecystectomy,ASAⅠ~Ⅱ class,were randomly divided into two groups,using intravenous anesthesia and intubation,intraoperative continuous intravenous injection of propofol and remifentanil to maintain anesthesia,and given intermittent vecuronium to maintain muscle relaxation.Patients in Group P(n=30)received pentazocine(0.5 mg/kg) by intravenous injection at 10 minutes before the end of the operation;Patients in Group F(n=30)received fentanyl(1 μg/kg) by intravenous injection at 10 minutes before the end of the operation.The time was recorded of the resumption of apontaneous respiration,eye opening and extubation,the VRS pain score at 5 minutes and 10 minutes after extubation,adverse reactions with nausea and vomiting and respiratory inhibition and dysthesia in the 24 hours after operation.Results: There was no statistical significance in VRS pain score after extubation(P>0.05).The time of resumption of apontaneous respiration,eye opening and extubation in Group P was significantly shorter than that in Group F(P<0.05),and there was no adverse reactions with nausea and vomiting and respiratory inhibition and dysthesia in the 24 hours after operation.Conclusion: Pentazocine(0.5mg/kg) by intravenous injection can release postoperative hyperalgesia induced by remifentanil based anesthesia.