小剂量右美托咪定对瑞芬太尼停药后痛觉过敏的抑制作用研究

目的观察小剂量右美托咪定对术中泵注瑞芬太尼引起的术后痛觉过敏的抑制作用。方法选择ASAⅠ～Ⅲ级全身麻醉胸部手术60例,随机分为实验组与对照组,每组各30例。观察两组术后舒芬太尼应用时间,术后24h应用舒芬太尼总量等指标。结果对照组和实验组的瑞芬太尼的术中平均泵注速度分别为（0.29±0.12）μg/（kg.min）和（0.28±0.15）μg/（kg.min）,差异无统计学意义;对照组比实验组应用舒芬太尼的时间明显提前,且术后24h应用舒芬太尼总量也明显增多。结论术后应用小剂量右美托咪定可以延长术后追加舒芬太尼的时间间隔,并可减少术后舒芬太尼用量,证实右美托咪定可以缓解瑞芬太尼引起的痛觉过敏。

Modulation of Remifentanil-induced Postoperative Hyperalgesia and Tolerance by Low Doses of Dexmedetomidine

Objective To investigate the postoperative analgesic effect of low doses of dexmedetomidine used in remifentanil-induced acute hyperalgesia.Methods A total number of sixty ASA Ⅰ～Ⅲ adult patients who undergoing Thoracic surgery were assigned Randomly to the experimental group and the control group with 30 cases per group.Some indexes such as sufentanil application time and sufentanil application quantity 24 hours after surgery were observed postoperatively.Results The mean remifentanil infusion rate was(0.29±0.12)μg/(kg·min) and(0.28±0.15)μg/(kg·min) in control group and experimental group,which was not different with each other.Intraoperative hemodynamic responses were similar in each group.Postoperative pain scores were significantly greater in control group.And these patients required sufentanyl significantly more than those in the experimental group in the first 24 postoperative hours.Conclusion Low doses of Dexmedetomidine had significant suppressive effect on patients with postoperative hyperalgesia after remifentanyl anesthesia.