右美托咪定对瑞芬太尼所致术后痛觉过敏与急性疼痛的影响

被引：28

作者：

肖纯 ^{[1
]}

卢波 ^{[2
]}

姚娟 ^{[2
]}

孙建良 ^{[1
]}

机构：

[1] 嘉兴市第一医院麻醉科

[2] 温州医学院附属第二医院育英儿童医院麻醉科

来源：

中华医学杂志 | 2013年 / 01期

关键词：

右美托咪定; 瑞芬太尼; 术后痛觉过敏;

D O I：

暂无

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

目的探讨右美托咪定对瑞芬太尼所致术后痛觉过敏与急性疼痛的影响及其可能机制。方法 2011年1月至2012年6月嘉兴市第一医院于全麻下行择期腹部外科手术患者120例,数字表随机分为大剂量瑞芬太尼+右美托咪定组(D组),大剂量瑞芬太尼组(L组)与小剂量瑞芬太尼组(S组)。观察患者术后机械性痛阈,疼痛视觉模拟(VAS)评分,吗啡消耗量以及镇静(Ramsay)评分。结果 3组患者术前机械性痛阈无明显差异。与基础值相比,S组患者术后机械性痛阈[T1:(57±18)g;T2:(61±13)g;T3:(59±13)g],较基础值[T0:(60±11)g]无明显降低(P>0.05)。术后各时间点L组机械性痛阈[T1:(42±14)g;T2:(40±13)g;T3:(41±16)g]与D组机械性痛阈[T1:(39±13)g;T2:(39±13)g;T3:(40±15)g]与S组相比明显降低(P<0.05),但L组与D组间机械性痛阈的差异无统计学意义。3组患者术后各时间点VAS评分差异无统计学意义。D组与S组患者术后48 h内吗啡消耗量分别为[(61±12)mg与(54±13)mg],与L组(78±24)mg相比,明显减少(P<0.05)。与S组相比D组患者术后吗啡消耗量进一步降低(P<0.05)。与D组相比,L组与S组术后12、24 h Ramsay评分分别为[T1:(1.6±0.3);T2:(1.5±0.3)]与[T1:(1.4±0.2);T2:(1.3±0.3)]较D组Ramsay评分T1:(3.0±0.3);T2:(2.3±0.4)明显降低(P<0.05)。结论右美托咪定能缓解瑞芬太尼全麻术后患者的痛觉过敏和急性疼痛,但此作用不依赖于其对瑞芬太尼所致的痛觉过敏的抑制,其机制需进一步研究。

引用

页码：44 / 47

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