Spray After Him With Sheen To Rui Fentanyl Anesthesia Effect Of Hyperalgesia

Objective:To observe the effect of pentazocine in preventing postoperative hyperalgesia induced by remifentanil based anesthesia, and to compare pentazocine and fentanyl in preventing postoperative hyperalgesia induced by remifentanil based anesthesiaMethods:60cases of Laparoscopic Cholecystectomy,ASA I-II class,were randomly divided into pentazocine(P group) and fentanyl(F group)two groups,using midazolam40μg/kg、fentanyl4μg/kg、etomidate0.15～0.2mg/kg、vecuronium bromide0.1mg/kg to do the induction of anesthesia, intravenous anesthesia and intubation,intraoperative continuous intravenous injection of propofol4～6mg·kg-1·h-1, and remifentanil0.1～0.4μg·kg-1·min-1to maintain anesthesia,and given intermittent vecuronium to maintain muscle relaxation,to stop the use of vecuronium at30minutes before the end of the operation..Patients in group P (n=30) were received pentazocine(0.5mg/kg) by intravenous injection at10minutes before the end of the operation; Patients in group F (n=30) were received fentanyl(lug/kg) by intravenous injection at10minutes before the end of the operation. Without any Opioid antagonists or analeptic drugs, remove the tracheal catheter after the natural recovery of patients. Patients were received oral administration of tramadol(50mg) When they were with moderate pain, if after1hour pain can not effectively relieved, the patients could receive another oral administration of tramadol(50mg). Records the time to resumption of apontaneous respiration,eye opening and extubation,the VRS pain score at5minutes,10minutes after extubation,adverse reactions with nausea and vomiting and respiratory inhibition and dysthesia and whether need the oral administration of tramadol in the24hours after operation.Results:l.The VRS pain score at5minutes after extubation:P group have22cases at0scores and8cases at1scores; F group have24cases at0scores and6cases at1scores, there was no statistical significance (P>0.05). The VRS pain score at10minutes after extubation:P group have21cases at0scores and9cases at1scores; F group have24cases at0scores and6cases at1scores, there was no statistical significance(P>0.05). There was no statistical significance of VRS pain score after extubation (P>0.05)2.The time to resumption of apontaneous respiration in group P (5.1±3.1min)was significant shorter than that in group F(7.8±2.1min)(P<0.05). The time to eye opening in group P (6.5±2.9min)was significant shorter than that in group F(9.2±2.3min)(P<0.05). The time to extubation in group P (8.3±3.1min)was significant shorter than that in group F(11.2±3.6min)(P<0.05).3.There was no adverse reactions with nausea and vomiting and respiratory inhibition and dysthesia and oral administration of tramadol in the24hours after operation. Conclusion:pentazocine(0.5mg/kg) by intravenous injection can release postoperative hyperalgesia induced by remifentanil based anesthesia,and to compare with fentanyl(0.5mg/kg) by intravenous injection,it could reduce the time to resumption of apontaneous respiration,eye opening and extubation significantly.