持续静注小剂量纳洛酮对瑞芬太尼所致痛觉敏化的影响

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Abstract Objective To investigate the effect of continuous intravenous injection of low-dose naloxone on remifentanil-induced hyperalgesia.Methods One hundred and twenty patients undergoing cholecystectomy were randomly assigned to receive continuous i.v. of either normal saline (group C) or naloxone 0.25 μg/(kg·h) (group N) during maintenance of general anesthesia. Normal saline or naloxone was injected fifteen minutes before the induction of anesthesia until five minutes before the end of the operation. The pain threshold, Visual Analogue Score(VAS) and Ramsay’s score were determined preoperatively(T₁) and postoperatively [0.5 h(T₂), 1 h(T₃), 2 h(T₄), 8 h(T₅), 12 h(T₆), 24 h(T₇) and 48 h(T₈)].Results In group C, the pain threshold at T₂ and T₃ was significantly lower than at T1 (P<0. 05), and the pain threshold between T₄ and T₈ was significantly higher than at T₁, (P<0.01). In group N, the pain threshold at different time points after operation was significantly higher than at T₁ (P<0. 01), and the Visual Analogue Score at T₂ and T₃ was significantly higher than that of T₄ to T₈(P<0.01). The pain threshold and Ramsay’s score at T₂ and T₃ in group N were significantly higher than those in group C, and the Visual Analogue Score at T₂ and T₃ was lower than in group C (P<0.01).Conclusions Continuous intravenous injection of low-dose naloxone during general anesthesia can help prevent remifentanil-induced hyperalgesia.

Key words： cholecystectomy low-dose Naloxone remifentanil hyperalgesia

Received: 12 May 2018

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	Articles by authors
	GAO Minglong
	LI Hongfang
	SUN Li
	LIU Qingqing
	ZHAO Hongyu
	DU Pengshuang
	MA Yaqun
	and LIU Yongzhe.

Cite this article:

GAO Minglong,LI Hongfang,SUN Li等. Effect of continuous intravenous injection of low-dose naloxone on remifentanil induced hyperalgesia[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(9): 888-891.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I9/888

[1]	Manchikanti L, Fellows B, Ailinani H, et al. Therapeutic use, abuse, and nonmedical use of opioids: a ten year perspective[J]. Pain Physician, 2010,13: 401-435.
[2]	赵丽云,叶铁虎,张银中,等.小剂量纳洛酮在术后吗啡静脉自控镇痛中的应用[J]. 中国医学科学院学报, 2005, 27(2): 228-231.
[3]	高明龙,文爱平,李爱珍,等. 吗啡联合不同剂量纳洛酮用于剖腹产病人术后镇痛[J]. 山西医科大学学报, 2007, 38(8): 741-744.
[4]	Karube N, Ito S, Sako S, et al. Sedative effects of oral pregabalin premedication on intravenous sedation using propofol target-controlled infusion[J]. Anesth, 2017, 31(4): 586-592.
[5]	Mauermann E, Filitz J, Dolder P, et al. Does fentanyl lead to opioid-induced hyperalgesia in healthy volunteers? a double-blind, randomized, crossover trial[J]. Anesthesiology, 2016, 124: 453-463.
[6]	Fletcher D, Martinez V. Opioid-induced hyperalgesia in patients after surgery: a systematic review and a metaanalysis[J]. Br J Anaesth, 2014, 112: 991-1004.
[7]	Tompkins D A, Smith M T, Bigelow G E, et al. The effect of repeated intramuscular alfentanil injections on experimental pain and abuse liability indices in healthy males[J]. Clin J Pain, 2014, 30: 36-45.
[8]	Zhang L, Shu R, Zhao Q, et al. Preoperative butorphanol and flurbiprofen axetil therapy attenuates remifentanil-induced hyperalgesia after laparoscopic gynaecological surgery: a randomized double-blind controlled trial[J]. Br J Anaesth, 2016, 117(4): 504 -511.
[9]	Tong J G. Poorly controlled postoperative pain: prevalence, consequences, and prevention[J]. J Pain Res, 2017, 10:2287-2298.
[10]	McDonnell C, Zaarour C, Hull R, et al. Pre-treatment with morphine does not prevent the development of remifentanil-induced hyperalgesia[J]. Can J Anaesth, 2008, 55(12): 813-818.
[11]	Leal P C, Salomão R, Brunialti M K, et al. Evaluation of the effect of ketamine on remifentanil-induced hyperalgesia: a double-blind, randomized study[J]. Clin Anesth, 2015, 27(4): 331-337.
[12]	Yalcin N, Uzun S T, Reisli R, et al. A comparison of ketamine and paracetamol for preventing remifentanil induced hyperalgesia in patients undergoing total abdominal hysterectomy [J]. Int J Med Sci, 2012, 9(5): 327 -333.
[13]	Schlimp C J, Pipam W, Wolrab C, et al. Clonidine for remifentanil-induced hyperalgesia: a double-blind randomized, placebo-controlled study of clonidine under intra-operative use of remifentanil in elective surgery of the shoulder[J]. Schmerz, 2011, 25(3): 290-295.
[14]	刘晴晴,刘永哲,高明龙,等. α2肾上腺素受体对术后痛觉敏化的调控[J]. 武警医学, 2018, 29(2): 201 -203.