关键词: 甲哌卡因, 瑞芬太尼, 腹横筋膜阻滞, 痛觉超敏

Abstract: ［Abstract］ Objective To investigate the effects of transversus abdominis plane block with mepivacaine on hyperalgesia，which was induced by remifentanil. Methods A total of 50 patients undergoing selective abdominal hysterectomy were randomly divided into mepivacaine group or control group. In mepivacaine group， 1.5% mepivacaine 20 mL was used for transversus abdominis plane block under ultrasound guidance on each side after anesthesia induction， whereas no transversus abdominis plane block was performed in control group. The anesthesia was maintained with sevoflurane at 0.8?1.1MAC and remifentanil at 0.05~0.3 μg/kg·min， which was adjusted depending on the hemodynamic changes and Bispectral index （BIS）. The total intraoperative consumption of remifentanil， the degrees of postoperative pain using visual analogue score （VAS score） at 1 h（VAS 1）， 3 h（VAS2）， 6 h（VAS3）， 12 h（VAS4）， and 24 h （VAS 5） after surgery， as well as the frequency of analgesics supplement and related complications were observed and compared. Results The intraoperative consumption of remifentanil in mepivacaine group was significantly lower than that in control group （P<0.05）， as well as the VAS score at each time point （P<0.05）. And the frequency of postoperative analgesics supplementation was also less than that in control group （P<0.05）. Conclusion Pretreatment of transversus abdominis plane block with mepivacaine can significantly reduce the consumption of intraoperative remifentanil， resulting in relieving hyperalgesia caused by remifentanil.

Key words: hyperalgesia, mepivacaine, remifentanil, transversus abdominis plane block