右美托咪定对瑞芬太尼持续输注下腹腔镜胆囊切除术患者机械痛觉阈值的影响

发布时间：2018-05-20 08:39

本文选题：右美托咪定 + 帕瑞昔布钠　；参考：《实用医学杂志》2015年21期

【摘要】：目的:观察右美托咪定(dexmedetomidine,Dex)对瑞芬太尼为镇痛药的全麻腹腔镜胆囊切除术患者机械痛觉域值的影响,明确Dex是否可以预防此类患者的痛觉过敏。方法:择期行腹腔镜胆囊切除手术患者120例,随机分为3组:右美托咪定组(D组)、帕瑞昔布钠组(P组)和对照组(C组)。各组麻醉维持用药为异丙酚及瑞芬太尼,D组加用Dex,P组加用帕瑞昔布钠,C组不使用Dex及帕瑞昔布钠。观察患者术后2、4、8、12、24、48 h的机械痛觉域值及视觉模拟评分(VAS)。结果:C组各时相点的痛觉阈值较术前显著下降(P0.01);P组仅术后12、24、48 h的痛觉阈值下降(P0.05);D组术后机械痛域值与术前相比差异无统计学意义(P0.05)。与C组比较,D组术后机械痛觉阈值皆增高,P组仅术后2、4、8 h的机械痛觉阈值增高;与P组比较,D组的机械痛觉阈值在术后12、24、48 h增加。与术前相比,各组术后各时间点的VAS值升高(P0.05),患者术后VAS值与机械痛觉阈值无相关性。结论:右美托咪定可以抑制瑞芬太尼麻醉下腹腔镜胆囊切除术患者的痛觉过敏,其抑制作用的持续时间优于帕瑞昔布钠。
[Abstract]:Aim: to observe the effect of dexmemedetomine Dexon on mechanical pain domain of patients undergoing general anesthesia laparoscopic cholecystectomy with remifentanil as analgesics, and to determine whether Dex can prevent hyperalgesia. Methods: one hundred and twenty patients undergoing laparoscopic cholecystectomy were randomly divided into three groups: dexmetomidine group (group D), paroxib sodium group (group P) and control group (group C). The maintenance drugs were propofol and remifentanil group D plus Dexabine P group plus paroxibumin sodium group C without Dex and paroxib sodium. The mechanical pain domain and visual analogue score (VASA) of the patients were observed at 2: 4, 8, 12, 24 and 48 h postoperatively. Results the threshold of pain in group C was significantly lower than that in group P 0.01 and P < 0.05; there was no significant difference in mechanical pain domain between group D and group D (P 0.05). Compared with group C, the threshold of mechanical pain in group D was higher than that in group C, and the threshold of mechanical pain in group D was higher than that in group D at 12: 24 and 48 hours after operation. Compared with pre-operation, the VAS value of each group was higher than that before operation (P 0.05). There was no correlation between VAS value and mechanical pain threshold. Conclusion: dexmetomidine can inhibit hyperalgesia in patients undergoing remifentanil anesthesia in laparoscopic cholecystectomy, and the duration of inhibition is longer than that of paroxib sodium.
【作者单位】：解放军421医院麻醉科;广州军区广州总医院麻醉科;
【基金】：国家自然科学基金面上项目(编号:81371233)
【分类号】：R614

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