中国临床药理学杂志2025，Vol.41Issue(18)：2611-2617,7.DOI:10.13699/j.cnki.1001-6821.2025.18.007
不同剂量阿芬太尼对腹腔镜胆囊切除术患者的临床研究
Clinical study on the effects of different doses of alfentanil on patients undergoing laparoscopic cholecystectomy
摘要
Abstract
Objective To observe the effects and safety of different doses of alfentanil injection on hyperalgesia after continuous infusion of remifentanil injection in patients undergoing laparoscopic cholecystectomy.Method The patients scheduled to undergo laparoscopic cholecystectomy were divided into group A,group B,group C and group D.Ten minutes before the end of the surgery,groups A,B and C were intravenously injected with alfentanil at doses of 5,15 and 25 μg·kg-1,respectively,while group D was injected with 0.9％NaCl.The hemodynamics indices[before anesthesia induction(T0),5 minutes after induction(T,),during intubation(T2),at skin incision(T3),during extubation(T4),10 minutes after extubation(T5)],quality of awakening,analgesia and sedation scores,incidence of postoperative hyperalgesia,inflammatory factors and safety were compared among the 4 groups.Results A total of 42 patients in each group were included in the statistical analysis.At T4,mean arterial pressure(MAP)values in groups A,B,C and D were(92.81±10.31),(87.50±10.33),(85.60±9.69)and(98.48±7.07)mmHg,respectively;heart rate(HR)values were(87.36±9.25),(81.76±9.35),(80.24±9.38)and(92.83±9.73)beat·min-1,respectively;at T5,MAP values were(95.40±8.63),(90.19±8.79),(89.71±8.86)and(99.48±8.72)mmHg,respectively;HR values were(92.31±8.56),(87.55±8.84),(86.24±8.64)and(97.33±8.51)beat·min-1,respectively;extubation time were(9.07±1.02),(9.38±1.25),(11.48±1.58)and(10.74±1.38)min;spontaneous breathing recovery time were(6.52±1.27),(6.86±1.28),(8.38±1.53)and(7.29±1.13)min;and PACU stay time were(22.64±4.57),(23.69±4.25),(32.95±4.62)and(27.26±4.98)min for groups A,B,C,and D,respectively;the incidence of hyperalgesia at 2 h postoperation were 4.76％(2 cases/42 cases),2.38％(1 cases/42 cases),0 and 21.43％(9 cases/42 cases),and at 24 h postoperation were 9.52％(4 cases/42 cases),4.76％(2 cases/42 cases),0 and 23.81％(10 cases/42 cases)in groups A,B,C,and D,respectively.Differences between group D and the other three groups were statistically significant(all P＜0.05).There were no obvious adverse drug reactions in groups A and D.Adverse drug reactions in group B included nausea and vomiting,and adverse drug reactions in group C included respiratory depression.The total adverse drug reactions in groups A,B,C,and D were 0％(0 cases/42 cases),2.38％(1 case/42 cases),4.76％(2 cases/42 cases),and 0％(0 cases/42 cases),respectively,and there were no statistically significant differences(all P＞0.05).Conclusion Compared with low dose alfentanil injection,high dose alfentanil injection applied in cholecystectomy can reduce hyperalgesia,effectively relieve pain,and alleviate inflammatory response,but the effect on improving the recovery quality of patients is not obvious.关键词
阿芬太尼注射液/瑞芬太尼注射液/腹腔镜胆囊切除术/痛觉过敏Key words
alfentanil injection/remifentanil injection/laparoscopic cholecystectomy/hyperalgesia分类
临床医学引用本文复制引用
王晓群,倪文静,周广伟,张满和..不同剂量阿芬太尼对腹腔镜胆囊切除术患者的临床研究[J].中国临床药理学杂志,2025,41(18):2611-2617,7.基金项目
河北省卫生健康委医学科学研究课题计划基金资助项目(20221803) （20221803）
