摘要
目的:探讨逐渐停药对瑞芬太尼持续输注下腹腔镜胆囊切除术患者痛觉过敏的影响,以期为临床缓解患者的痛觉敏感提供新的途径。方法:选取2018年1月-2019年12月在中山市小榄人民医院住院治疗且择期行腹腔镜胆囊切除术的患者108例,根据随机数字表法将患者分为对照组和研究组,每组54例。对照组患者给予持续输注瑞芬太尼,给药速率为0.3 μg/(kg·min);研究组患者给予逐渐停药方案。记录两组患者的麻醉时间及拔管时间,评价两组患者苏醒即刻、术后6 h、术后24 h的疼痛程度,吗啡消耗量,痛觉过敏程度以及术后不良反应发生情况,并分析痛觉过敏程度与疼痛程度、吗啡消耗量的相关性。结果:两组麻醉时间,拔管时间,术前及术后6、24 h VAS评分,术后6、24 h吗啡消耗量比较,差异均无统计学意义(P>0.05);两组术前痛觉过敏阈值比较,差异无统计学意义(P>0.05),研究组术后6、24 h的痛觉过敏阈值均高于对照组,差异均有统计学意义(P<0.05)。两组患者的恶心、头痛、头晕以及寒战的发生率比较,差异无统计学意义(P>0.05)。经Pearson相关性分析得出痛觉过敏程度与术后6 h和术后24 h VAS评分之间均无显著相关性(P>0.05);痛觉过敏程度与术后6 h和术后24 h吗啡消耗量之间均无显著相关性(P>0.05)。结论:逐渐停药可以提升瑞芬太尼持续输注下腹腔镜胆囊切除术患者的疼痛阈值,缓解疼痛过敏,对临床具有积极的指导意义。
Objective:To investigate the effect of gradual withdrawal on hyperalgesia in patients undergoing laparoscopic cholecystectomy with continuous infusion of Remifentanil.Method:A total of 108 patients who underwent laparoscopic cholecystectomy in Zhongshan Xiaolan People’s Hospital from January 2018 to February 2019 were enrolled.Patients were randomly divided into control group and study group according to the digital table method,54 cases in each group.Patients in the control group were given continuous infusion of Remifentanil at a rate of 0.3 μg/(kg·min);patients in the study group were given a gradual withdrawal schedule.The anesthesia time and extubation time of the two groups were recorded.The pain degree immediately after awakening,6 h after operation and 24 h after operation,Morphine consumption,degree of hyperalgesia and postoperative adverse reactions of the two groups were evaluated,the correlation between the degree of hyperalgesia and the degree of pain,Morphine consumption was analyzed.Result:There were no statistically significant differences in anesthesia time,extubation time,VAS scores before and 6 and 24 h after operation,Morphine consumption at 6 and 24 h after operation between the two groups (P>0.05).There was no statistically significant difference in the hyperalgesia threshold between the two groups before operation (P>0.05).The hyperalgesia thresholds in the study group at 6 and 24 h after operation were higher than those of the control group,and the differences were statistically significant (P<0.05).There was no significant difference in the incidence of nausea,headache,dizziness and chills between the two groups (P>0.05).Pearson correlation analysis showed that there were no significant correlations between the degree of hyperalgesia and the VAS score at 6 h and 24 h after operation (P>0.05);there were no significant correlations between the degree of hyperalgesia and Morphine consumption at 6 h and 24 h after operation (P>0.05).Conclusion:Gradual withdrawal can improve the pain threshold of patients with laparoscopic cholecystectomy under continuous infusion of Remifentanil,relieve pain allergy,and have positive guiding significance for the clinic.
作者
李欢
王韬
李辉
扶晟
李瑞钰
王立勋
LI Huan;WANG Tao;LI Hui;FU Sheng;LI Ruiyu;WANG Lixun(Zhongshan Xiaolan People’s Hospital,Guangdong Province,Zhongshan 528415,China;不详)
出处
《中国医学创新》
CAS
2022年第8期55-59,共5页
Medical Innovation of China
基金
中山市医学科研项目(2016A020245)。
关键词
逐渐停药
瑞芬太尼
持续输注
腹腔镜
胆囊切除
痛觉过敏
Gradual withdrawal
Remifentanil
Continuous infusion
Laparoscopy
Cholecystectomy
Hyperalgesia
