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右美托咪定上调外周血微小RNA 183以改善瑞芬太尼相关痛觉过敏

[Dexmedetomidine up-regulates peripheral blood microRNA 183 to improve remifentanil-related hyperalgesia].

作者信息

Luo Y, Wang L, Li G W, Yang Z Y, Lin X Z

机构信息

Department of Anesthesiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2021 May 11;101(17):1246-1249. doi: 10.3760/cma.j.cn112137-20200825-02467.

Abstract

To investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and its underlying mechanism through a prospective cohort study. From July 2018 to July 2019, 80 patients who underwent day surgery in Taizhou Central Hospital (including patients with laparoscopic cholecystectomy and oophorocystectomy) were selected, there were 46 males and 34 females with a mean age of (28.8±4.3) years. The patients were divided into dexmedetomidine group and control group with random number table, 40 cases in each group. After anesthesia induction, the dexmedetomidine group was managed with intravenous infusion of dexmedetomidine (1 μg/kg) within 10 minutes, while the control group was treated with an equal volume of normal saline. The patient's general information and the intraoperative data were recorded. The visual analogue scale (VAS) was evaluated before the operation and 1, 6 and 12 h after the surgery. The Von Frey cilia method was conducted to determine the mechanical pain threshold of the patient's non-surgical body parts. The vein blood was extracted at the corresponding time point to evaluate the expression level of miR-183 via the RT-PCR method. The demographic and preoperative parameters were comparable between the two groups. Compared with the control group, the mechanical pain threshold in the dexmedetomidine group increased significantly at 1, 6, and 12 h after surgery (all <0.05), and the VAS score at the corresponding time point declined significantly (all 0.05). At the same time points, the serum miR-183 levels in the dexmedetomidine group were all significantly higher than those in the control group after surgery (2.07±0.41 vs 1.68±0.60, 1.99±0.33 vs 1.74±0.54, 1.88±0.36 vs 1.67±0.54, respectively, all <0.05). A perioperative dose of dexmedetomidine in day surgery can significantly improve the remifentanil-related hyperalgesia, and it may be related to up-regulation of the expression of miR-183 in the blood.

摘要

通过一项前瞻性队列研究,探讨右美托咪定对瑞芬太尼诱导的痛觉过敏的影响及其潜在机制。选取2018年7月至2019年7月在台州市中心医院接受日间手术的80例患者(包括腹腔镜胆囊切除术和卵巢囊肿切除术患者),其中男性46例,女性34例,平均年龄(28.8±4.3)岁。采用随机数字表法将患者分为右美托咪定组和对照组,每组40例。麻醉诱导后,右美托咪定组在10分钟内静脉输注右美托咪定(1μg/kg),而对照组给予等量生理盐水。记录患者的一般资料和术中数据。在手术前以及术后1、6和12小时评估视觉模拟评分(VAS)。采用von Frey纤毛法测定患者非手术部位的机械性疼痛阈值。在相应时间点采集静脉血,通过RT-PCR法评估miR-183的表达水平。两组的人口统计学和术前参数具有可比性。与对照组相比,右美托咪定组术后1、6和12小时的机械性疼痛阈值显著升高(均P<0.05),相应时间点的VAS评分显著下降(均P<0.05)。在相同时间点,右美托咪定组术后血清miR-183水平均显著高于对照组(分别为2.07±0.41 vs 1.68±0.60、1.99±0.33 vs 1.74±0.54、1.88±0.36 vs 1.67±0.54,均P<0.05)。日间手术围手术期给予右美托咪定可显著改善瑞芬太尼相关的痛觉过敏,这可能与血液中miR-183表达上调有关。

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