[Efficacy and safety of remifentanil-based regimen for postoperative pain management in abdominal surgery patients: a double-blind study with low-dose remifentanil infusion of 0.02 microg x kg(-1) x min(-1)].
[Efficacy and safety of remifentanil-based regimen for postoperative pain management in abdominal surgery patients: a double-blind study with low-dose remifentanil infusion of 0.02 microg x kg(-1) x min(-1)].
复制标题
基于瑞芬太尼方案治疗腹部手术患者术后疼痛的有效性和安全性：0.02μg×kg(-1)×min(-1)小剂量瑞芬太尼输注双盲研究
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Asami Machino
中科院分区：
文献类型：
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作者：
Y. Nagasaka;M. Wakamatsu;H. Hirano;Reimi Shirasaki;Takeshi Kaida;Asami Machino
背景
瑞芬太尼是一种强效镇痛药，起效快，作用持续时间超短。即使在长时间输注后，其上下文相关的半衰期也始终很短。瑞芬太尼可以有效提供更好的术后镇痛效果，但这种方法在日本并未得到普遍接受。本研究旨在记录低剂量瑞芬太尼输注对术后患者的疗效和安全性。
方法
对 40 名接受腹部手术的患者进行了前瞻性研究。他们被随机分配到瑞芬太尼（0.02 µg x kg(-1) x min(-1)）组或安慰剂组。术后所有患者均接受利多卡因连续硬膜外麻醉和芬太尼静脉自控镇痛。仅当疼痛未缓解时才给予氟比洛芬。在 12 小时内，每隔 3 小时检查视觉模拟量表 (VAS)、芬太尼和氟比洛芬的需要量以及瑞芬太尼相关不良反应（呼吸抑制、恶心、呕吐、瘙痒）的发生率。
结果
两组之间的疼痛评分没有统计学差异。在整个研究过程中，两组均未发生包括呼吸抑制在内的不良事件。
结论
瑞芬太尼输注0.02μg×kg(-1)×min(-1)可以安全使用，不会出现任何严重不良事件，但可能不足以用于术后镇痛。该药物用于术后镇痛的最佳剂量仍有待阐明。
BACKGROUND
Remifentanil is a powerful analgesic with fast onset and ultra-short duration of action. Its context-sensitive half-time is consistently short even after a prolonged infusion. Remifentanil is effective for providing better postoperative analgesia, but this method is not generally accepted in Japan. The present study was conducted to document efficacy and safety of low-dose remifentanil infusion in postoperative patients.
METHODS
Forty patients undergoing abdominal surgery were studied prospectively. They were randomly assigned to either remifentanil (0.02 microg x kg(-1) x min(-1)) or placebo group. Postoperatively all patients received continuous epidural anesthesia with lidocaine and IV patient-controlled analgesia with fentanyl. Flurbiprofen was administered only when no pain relief was achieved. Visual analogue scale (VAS), requirement of fentanyl and flurbiprofen, and the incidence of remifentanil-related adverse effects (respiratory depression, nausea, vomiting, pruritus) were examined at 3 hourly intervals for 12 hours.
RESULTS
There are no statistical differences between two groups in pain scores. No adverse events including respiratory depression occurred throughout the study in both groups.
CONCLUSIONS
Remifentanil infusion at 0.02 microg x kg(-1) x min(-1) can safely be used without any serious adverse events, while it may not be enough for postoperative analgesia. The best dosage of this drug for postoperative analgesia remains to be elucidated.