本文選題：右美托咪定 + 帕瑞昔布鈉　； 參考：《實(shí)用醫(yī)學(xué)雜志》2015年21期

【摘要】：目的:觀察右美托咪定(dexmedetomidine,Dex)對瑞芬太尼為鎮(zhèn)痛藥的全麻腹腔鏡膽囊切除術(shù)患者機(jī)械痛覺域值的影響,明確Dex是否可以預(yù)防此類患者的痛覺過敏。方法:擇期行腹腔鏡膽囊切除手術(shù)患者120例,隨機(jī)分為3組:右美托咪定組(D組)、帕瑞昔布鈉組(P組)和對照組(C組)。各組麻醉維持用藥為異丙酚及瑞芬太尼,D組加用Dex,P組加用帕瑞昔布鈉,C組不使用Dex及帕瑞昔布鈉。觀察患者術(shù)后2、4、8、12、24、48 h的機(jī)械痛覺域值及視覺模擬評分(VAS)。結(jié)果:C組各時(shí)相點(diǎn)的痛覺閾值較術(shù)前顯著下降(P0.01);P組僅術(shù)后12、24、48 h的痛覺閾值下降(P0.05);D組術(shù)后機(jī)械痛域值與術(shù)前相比差異無統(tǒng)計(jì)學(xué)意義(P0.05)。與C組比較,D組術(shù)后機(jī)械痛覺閾值皆增高,P組僅術(shù)后2、4、8 h的機(jī)械痛覺閾值增高;與P組比較,D組的機(jī)械痛覺閾值在術(shù)后12、24、48 h增加。與術(shù)前相比,各組術(shù)后各時(shí)間點(diǎn)的VAS值升高(P0.05),患者術(shù)后VAS值與機(jī)械痛覺閾值無相關(guān)性。結(jié)論:右美托咪定可以抑制瑞芬太尼麻醉下腹腔鏡膽囊切除術(shù)患者的痛覺過敏,其抑制作用的持續(xù)時(shí)間優(yōu)于帕瑞昔布鈉。
[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.
【作者單位】： 解放軍421醫(yī)院麻醉科;廣州軍區(qū)廣州總醫(yī)院麻醉科;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(編號:81371233)
【分類號】：R614

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