摘要
目的探讨术前静脉滴注右美托咪定对瑞芬太尼复合麻醉患者术后急性阿片类药物耐受的影响。方法择期拟行腹腔镜胆囊切除术患者50例,ASAⅠ～Ⅱ级,年龄21～65岁,随机分成2组﹙n=25﹚:右美托咪定组﹙A组﹚和对照组﹙B组﹚。分别在麻醉诱导前20 min静脉滴注右美托咪定50μg﹙加入100 mL生理盐水中﹚、100 mL生理盐水,两组均靶控输注瑞芬太尼和丙泊酚复合麻醉。术后在麻醉复苏室,当VAS评分>3分时,静脉注射芬太尼20μg,5 min后重复注射,直至VAS评分<3分。30 min后连接PCIA泵送返病房,记录PACU内芬太尼用量﹑术后48 h内PCIA芬太尼用量﹑PCIA总按压次数和有效按压次数,观察不良反应的发生情况。结果与B组比较,A组术后PACU内芬太尼用量减少,差异有统计学意义(P<0.05);术后48 h内总按压次数和有效按压次数及芬太尼用量差异无统计学意义(P>0.05)。结论术前20 min静脉注射右美托咪定50μg可有效减轻瑞芬太尼复合麻醉患者术后早期的急性阿片类药物耐受。
Objective To investigate the effect of dexmedetomidine on acute opioid tolerance after remifentanil based anesthesia. Methods Fifty ASA Ⅰ or Ⅱ patients aged 21-65 years undergoing laparoscopic cholecystectomy under general anesthesia were randomly divided into 2 groups （n = 25 each）： dexmedetomidine control group （group A） and antithesis control group （group B）. Two groups were intravenously injected dexmedetomidine （50 μg dissolved in 100 mL saline） or tales doses of saline for 20 min before induction. Anesthesia was induced and maintained with TCL of remifentanil and propofol. Pain in PACU was controlled by intermittent iv boluses of fentanyl （20 μg） till VAS 〈 3. Patients were send to sickroom 30 rain later and PCIA with fentanyl was used. Fentanyl consumption in PACU during the first thiry minutes after operation, Fentanyl consumption of PCIA,the number of attempts and the number of successful delivered doses was recorded. Results Fentanyl consumption was significantly lower in group A than in group B in PACU （P 〈 0.05）;There was nosignificantdifference in fentanyl consumption of PCIA （P 〉 0.05）. Conclusion Preoperative administration of dexmedetomidine iv （50 μg） can reduce acute opioid tolerance after remifentanil-based anesthesia in patients.
出处
《中国现代医生》
2012年第7期47-48,50,共3页
China Modern Doctor
