Objective: To explore the effects of lappaconitine on intraoperative administration of remifentanil induced postoperative hyperalgesia in general anaesthesia patients. Methods: One hundred and twenty patients from March to October 2016 undergoing elective thyroid operation under general anaesthesia at Ningbo NO.2 hospital, American Society of Anesthesiologists(ASA) Ⅰ or Ⅱ grade, aged 20-60, were enrolled in this study and randomly assigned to 3 groups (n=40). Remifentanil was intraoperatively infused at 0.1 μg·kg(-1)·min(-1) (Group S) or 0.3 μg·kg(-1)·min(-1) (Groups L and G), and patients in group G received lappaconitine 8 mg 30 minutes before the ending of surgery. Mechanical pain thresholds, visual analogue scale (VAS) and additional analgesics were recorded at 2, 6 and 24 hours after the operation. Results: There was no significant difference among the VAS and additional analgesics in three groups at 2, 6 and 24 h after operation (all P>0.05). There was no significant difference among the mechanical pain thresholds in three groups before and 2 h after operation (all P>0.05). The mechanical pain thresholds of group S, L and G was (45.7±15.6), (35.8±15.0), (47.6±16.4)g at 6 h and (50.7±17.0), (33.7±14.0), (49.7±13.9 )g at 24 h after operation. There was significant difference among the mechanical pain thresholds in group S, L and G at 6 h and 24 h after operation (F=6.586, 16.089, all P<0.01). Compared to group S, the mechanical pain thresholds significantly decreased in group L at 6 h and 24 h after operation (q=2.837, 5.045, all P<0.01). While there was a significantly increase in pain thresholds at 6 h and 24 h postoperatively in group G, as compared with the group L (q=3.384, 4.770, all P<0.01). Conclusion: Lappaconitine significantly alleviated intraoperative administration of remifentanil induced postoperative hyperalgesia in general anaesthesia patients.
目的： 观察高乌甲素对瑞芬太尼持续输注所致术后痛觉过敏的影响。 方法： 选择2016年3至10月宁波市第二医院接受择期甲状腺手术患者120例。年龄20～60岁，美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级。采用随机数字表法将患者分为3组(n＝40)：S组(小剂量瑞芬太尼组，0.1 μg·kg(－1)·min(－1))，L组(大剂量瑞芬太尼组，0.3 μg·kg(－1)·min(－1))，G组(高乌甲素＋大剂量瑞芬太尼组，0.3 μg·kg(－1)·min(－1))，手术结束前30 min给予G组患者静脉注射8 mg高乌甲素。记录术后2、6、24 h时的机械痛阈值、疼痛视觉模拟评分(VAS)和镇痛药物消耗量。 结果： 3组患者术后2、6、24 h VAS评分和吗啡累积消耗量差异均无统计学意义(均P>0.05)；3组患者术前和术后2 h的机械痛阈值差异均无统计学意义(均P>0.05)。S组、L组和G组术后6 h机械痛阈值分别为(45.7±15.6)、(35.8±15.0)、(47.6±16.4)g，术后24 h分别为(50.7±17.0)、(33.7±14.0)、(49.7±13.9)g，差异均有统计学意义(F＝6.586、16.089，均P<0.01)。与S组比较，L组患者术后6、24 h的机械痛阈值显著降低(q＝2.837、5.045，均P<0.01)，而G组患者术后6、24 h的机械痛阈值明显高于L组(q＝3.384、4.770，均P<0.01)。 结论： 高乌甲素能够缓解大剂量瑞芬太尼持续输注所致的术后痛觉过敏。.
Keywords: Hyperalgesia; Lappaconitine; Pain threshold; Remifentanil.