Dissertation
Dissertation > Medicine, health > Surgery > Surgical operation > Anesthesiology > General anesthesia > Intravenous anesthesia

The Inhibitive Effects of Dexmedetomidine on Remifentanil-induced Postoperative Hyperalgesia

Author JiaShuShan
Tutor WangDeMing
School Nanhua University
Course Surgery
Keywords remifentanyl Dexmedetomidine hyperalgesia sufentanil
CLC R614.24
Type Master's thesis
Year 2011
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Objective: To investigate the postoperative analgesic effect of Dexmedetomidine in remifentanil-induced acute opioid tolerance and hyperalgesia.Methods: Sixty ASAⅠ~Ⅱadult patients who undergoing esophageal cancer surgery were assigned randomly to group D (experimental group) and group C (control group) with 30 cases each. Either group was induced with midazolam 0.10mg/kg, Cisatracurium 0.15mg/kg, remi-fentanyl 1.5μg/kg via intravenous injection and tracheal intubation. Remifentanil at 0.1 5μg·kg-1·min-1 and Sevoflurane titrated to autonomic responses. Sevoflurane and remifentanil was discontinued at the end of operation in both group, at the same time application of Patient-controlled analgesia pum.The patients of group D were given dxmedetomidine at the rate of 1.0μg·kg-1·h-1 since remifentanil and remifentani was discontinued until 30 minutes after tracheal extubation. And the patients of control group were given NS until 30 minutes after tracheal extubation. Sufentanil was injected intravenously accroding to the NBP, HR and VAS scores in either group. VAS scores and Sufentanil consumption were recorded for 24 hours postoperation .Results: The mean remifentanil infusion rate was (0.18±0.02)μg﹒kg-1﹒min-1 and(0.17±0.03)μg﹒kg-1﹒min-1 in group C and group D respectively, without significnt difference(P>0.05). Intraoperative hemodynamic responses were similar in two groups. The time interval between application of sufentanil was (5.21±0.78)min, (10.35±0.82)min (P <0.05), respectively. The usage of sufentanil was(60.8±3.65)μg, (43.55±2.44)μg (P <0.05) respectively.Conclusion: Postoperative application of dexmedetomidine can significantly reduce visual analog scale, extending The time interval of sulfentanil application after extubation, and reduce the amount of sufentanil after surgery. Dexmedetomidine could relieve remifentanil-induced acute opioid tolerance and hyperalgesia.

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