Son Ilsoon, Oh Chung-Sik, Choi Jae Won, Kim Seong-Hyop
Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Republic of Korea.
Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Republic of Korea ; Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul 143-701, Republic of Korea.
ScientificWorldJournal. 2014;2014:701329. doi: 10.1155/2014/701329. Epub 2014 May 13.
This study assessed the effect of sufentanil administered before conclusion of remifentanil-based anaesthesia on postoperative hyperalgesia and haemodynamic stability in patients undergoing laparoscopic gynaecological surgery. The patients were randomly allocated to a sufentanil administration group (S group) or a normal saline administration group (C group). Anaesthesia was induced and maintained with controlled administration of remifentanil at 10 ng · mL(-1) and propofol under bispectral index guidance. Once the surgical specimen was procured, sufentanil or normal saline was administered at 0.15 ng · mL(-1) and maintained until extubation. The haemodynamic status during anaesthetic emergence was evaluated. The pain and postoperative nausea and vomiting (PONV) were assessed for 72 h following postanaesthetic care unit (PACU) discharge. The S group had significantly lower mean systemic arterial blood pressure and heart rate changes between the start of drug administration and extubation. Postoperative pain was significantly lower in the S group until 24 h following PACU discharge. There were no significant differences in PONV incidence and severity 72 h after PACU discharge between the two groups. Sufentanil administration before concluding remifentanil-based anaesthesia improved postoperative hyperalgesia and achieved haemodynamic stability at extubation without delaying recovery or increasing PONV during laparoscopic gynaecological surgery. Clinical trial registration is found at KCT0000785.
本研究评估了在基于瑞芬太尼的麻醉结束前给予舒芬太尼对接受腹腔镜妇科手术患者术后痛觉过敏和血流动力学稳定性的影响。患者被随机分为舒芬太尼给药组（S组）或生理盐水给药组（C组）。在脑电双频指数引导下，通过控制输注10 ng·mL⁻¹瑞芬太尼和丙泊酚诱导并维持麻醉。一旦获取手术标本，以0.15 ng·mL⁻¹的剂量给予舒芬太尼或生理盐水，并持续至拔管。评估麻醉苏醒期间的血流动力学状态。在麻醉后监护病房（PACU）出院后72小时内评估疼痛及术后恶心呕吐（PONV）情况。S组在给药开始至拔管期间平均体循环动脉血压和心率变化显著更低。在PACU出院后24小时内，S组的术后疼痛显著更低。两组在PACU出院后72小时的PONV发生率和严重程度无显著差异。在基于瑞芬太尼的麻醉结束前给予舒芬太尼可改善术后痛觉过敏，并在腹腔镜妇科手术拔管时实现血流动力学稳定，且不延迟恢复或增加PONV。临床试验注册号为KCT0000785。
