帕瑞昔布钠不同给药时机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

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1、万方数据424主堡壁竖堂壁查垫!!堡!旦星翌鲞整!塑鱼!也』垒塑些型型：垒哑!垫!!!!坚：垫：№：!·疼痛诊疗与研究·帕瑞昔布钠不同给药时机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陈亚军刘宏伟李清于泳浩【摘要】目的探讨帕瑞昔布钠不同给药时机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。方法择期拟行胆囊切除术患者54例，ASAI或Ⅱ级，年龄30—64岁，随机分为3组(，l=18)：均靶控输注异丙酚(血浆靶浓度3剧IIll)和瑞芬太尼(血浆靶浓度4ng，m1)行麻醉诱导和维持，I组和Ⅱ组分别于麻醉前30rain、术毕前30min静脉注射帕瑞昔布钠40m

2、g，C组为对照组。术后在麻醉复苏室30min内每隔5min询问患者的疼痛情况，疼痛评分>0分时，静脉注射吗啡2rag，30rain后连接病人自控静脉镇痛泵(按压1次吗啡剂量1mg，锁定时间5min)返回病房，记录术后30rain内、30min一24h及24—48h的吗啡用量，观察不良反应的发生情况。结果与c组比较，I组术后48h内各时段、Ⅱ组术后30min一24h及24—48h的吗啡用量降低(P0．05)；与I组比较，Ⅱ组术后30rain内吗啡用量升高(P<0．05)。各组均未见不良反应发生。结论麻醉前30ra

3、in静脉注射帕瑞昔布钠40mg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。【关键词】环加氧酶抑制药；哌啶类；镇痛药，阿片类；药物耐受性EffectsofdifferenttimeadministrationOfparecoxib鲥ltumoilacuteopioidtolerance缸抛rremifentanil-basedanesthesiaCHENYo．jm，LIUHong-wei，LIQ昀，YUYong-lmo．DepartmemofAnesthesiology，‰，咖MedicalUmvers矗yGeneralHospital，TianjiI

4、t300052，ChinaCorrespondingauthor：YUYong-hao，Email：yuyonghao@126．COrn【Abstract】OMectiveToinvestigatetheeffectsofdifferenttimeadministrationofparecoxibsodiumonacuteopioidtoleranceafterremifentanil-basedanesthesiainpatients．MethodsFifty-fourASAIorⅡpatientsaged30-64yrundergoingtransabdomin

5、alcholecystectomywererandoIIllydividedinto3groups(n=18each)：groupIreceivedparecoxib40ragat30rainbeforeanesthesia；groupIIreceivedpare地oxib40mgat30minbeforeterminationofanesthesia；groupCcontr01．AnesthesiawasinducedandmaintainedwithpropofolandremifentaniladministeredviaTCI．Thetargetplasma

6、concentrationofpropofolw船setat3t_￡g／mlandthatofremifentanilat4ns／n【11．Trachealintubationwasfacilitatedwithrocuronium0．6mg，kg．Musclerelaxationwa$maintainedwithintermittentivbolusesofvecuronimnduringoperation．Painwagassessedusingbehavioralp且inSCOre(O=quietandnopain，I=complaining，2=severe

7、painand／oragitation)．Whenthepain目O．Ore>0，thepatientsreceivedivinjectionofmorphineandthenPCIAwithmorphine(bolusdose1mg，lockoutinterval5min，nobackgroundinfusion)30minlater．Morphineconsumptionandsideeffectswererecordedwithin30rain，andduring30min-24hand24-48hafteroperation．ResultsCompare