关键词: 瑞芬太尼, 痛觉过敏, 右美托嘧啶, 帕瑞昔布, 老年患者

Abstract: 【Abstract】〓Objective〓To investigate the impact of pre-treatment or post-treatment with dexmet-omidine and parecoxib on remifentanil-induced hyperalgesia in elderly patients. Methods〓Sixty elderly patients(ASA Ⅱ or Ⅲ) scheduled for elective laparoscopic cholecystectomy were randomized into three groups(n=20), pre-treatment group (group A), post-treatment group (group B) and control group (group C). Intravenous infusions of 0.2 μg/kg dexmedetomidine and 40 mg parecoxib were given 30 min before induction in patients of group A or 30 min after remifentanil infusion in group B, while patients in group C were injected with saline, respectively. Surgery and anesthesia duration, time to extubation, sedation score, VAS pain score, usage of analgesics, and the incidences of adverse effects were recorded. Results〓The VAS scores both in group A and group B were significantly lower than that of group C after surgery (P<0.05). The postoperative usages of fentanyl in group A, B and C were 246.25±17.09 μg,.326.20±19.78 μg and 479.50±18.84 μg,.with any two groups differentiating significantly.(P<0.01). The need for additional analgesic in group A was later than that of group B and C,.and faster pain relief was obtained in group A after using analgesics. Additionally, administration of dexmedetomidine combined with parecoxib also decreased the incidences of postoperative nausea and vomiting,.with no significance between group A and B. Conclusion Preoperative or intraoperative injection of dexmedetomidine and parecoxib can significantly alleviate remifentanil-induced hyperalgesia in elderly patients and can reduce the incidence of postoperative nausea and vomiting, better outcome gained when managing preoperatively.

Key words: Remifentanil, Hyperalgesia, Dexmedetomidine, Parecoxib, Elderly