逐渐停用与立即停用瑞芬太尼对全凭静脉麻醉下腹腔镜子宫肌瘤剥除术后患者痛觉过敏及应激反应的影响  

Effects of gradual discontinuation and immediate discontinuation of remifentanil on hyperalgesia and stress response in patients undergoing laparoscopic myomectomy under total intravenous anesthesia

作　　者：张智尧 宋巍 ZHANG Zhiyao;SONG Wei(People's Hospital of Tongchuan,Tongchuan 727000,China)

机构地区：[1]铜川市人民医院,陕西铜川727000

出　　处：《临床医学研究与实践》2023年第35期88-91,共4页Clinical Research and Practice

摘　　要：目的探讨逐渐停用与立即停用瑞芬太尼对全凭静脉麻醉下腹腔镜子宫肌瘤剥除术后患者痛觉过敏及应激反应的影响。方法选取2019年12月至2021年12月我院收治的80例全凭静脉麻醉下腹腔镜子宫肌瘤剥除术患者为研究对象,根据瑞芬太尼停用方式的不同将其分为A组和B组,各40例。两组均行全凭静脉麻醉,A组术后逐渐停用瑞芬太尼,B组术后立即停用瑞芬太尼。比较两组的应用效果。结果术后6 h,A组的痛阈值高于B组,数字疼痛分级量表(NRS)评分低于B组,差异具有统计学意义(P<0.05)。术后6 h,A组的神经肽Y(NPY)、P物质(SP)水平低于B组,差异具有统计学意义(P<0.05)。术后6 h,A组的皮质醇(Cor)、去甲肾上腺素(NE)水平低于B组,差异具有统计学意义(P<0.05)。结论相较于立即停用瑞芬太尼,逐渐停用瑞芬太尼可改善全凭静脉麻醉下腹腔镜子宫肌瘤剥除术后患者的痛觉过敏情况,减轻疼痛和应激反应。Objective To investigate the effects of gradual discontinuation and immediate discontinuation of remifentanil on hyperalgesia and stress response in patients undergoing laparoscopic myomectomy under total intravenous anesthesia.Methods A total of 80 patients with laparoscopic myomectomy under total intravenous anesthesia admitted in our hospital from December 2019 to December 2021 were selected as the research objects.According to the different ways of discontinuation remifentanil,the patients were divided into group A and group B,with 40 cases in each group.Both groups underwent total intravenous anesthesia,the group A was given gradual discontinuation of remifentanil after operation,and the group B was given immediate discontinuation of remifentanil after operation.The application effects of the two groups were compared.Results At 6 h after operation,the pain threshold of the group A was higher than that of the group B,and the Numerical Rating Scale(NRS)score was lower than that of the group B,the differences were statistically significant(P<0.05).At 6 h after operation,the levels of neuropeptide Y(NPY)and substance P(SP)in the group A were lower than those in the group B,the differences were statistically significant(P<0.05).At 6 h after operation,the levels of cortisol(Cor)and norepinephrine(NE)in the group A were lower than those in the group B,the differences were statistically significant(P<0.05).Conclusion Compared with immediate discontinuation of remifentanil,gradual discontinuation of remifentanil can improve the hyperalgesia of patients after laparoscopic myomectomy under total intravenous anesthesia,and reduce pain and stress response.

关 键 词：全凭静脉麻醉 腹腔镜子宫肌瘤剥除术 逐渐停用 立即停用 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学]