Remifentanil produces the phenomenon of super-sensitive mechanism and prevention.docVIP

 PAGE \* MERGEFORMAT 16 Remifentanil produces the phenomenon of super-sensitive mechanism and prevention 1, super-sensitive phenomenon Opioid drugs are the treatment of moderate to severe pain, the main drug in recent years in both animal experiments and clinical discovery and high-sensitivity phenomenon, that is, use of opioid drugs, increased sensitivity to harmful stimuli, a phenomenon that the use of short - Xiao-opioid drugs such as remifentanil after the more apparent. Hypersensitivity phenomena can be clinically manifested as pain hypersensitivity (hyperalgesia), which reduce the pain threshold, pain after surgery the wound is more severe, but also showed abnormal pain (allodynia), namely, normal individuals do not produce pain, light touch and so on may have severe pain. Second, super-sensitive mechanism of the phenomenon of Guignard, etc. confirmed in major abdominal surgery after use of remifentanil, postoperative pain occurred much earlier and stronger requirements for postoperative opioid drugs increased after 24h compared with the inhalation dosage of morphine almost doubled in the latter , the authors believe that a larger dose of remifentanil after use is easy to produce acute opioid drug tolerance and hypersensitivity phenomena. Hansen observed that remifentanil 0.4μg/kg/min after use in abdominal major surgery, postoperative 2hVAS compared with the control group, significant difference (40mm, control group 13mm). Hood in 10 cases of the study volunteers to give local capsaicin and intermittent heat stimulation, target-controlled infusion of remifentanil (3.1 ± 1.2ng/ml) to mitigate, in the 4h after the discontinuation of remifentanil, ultra-sensitive area to the original 180 ± 47% and 180 ± 86%. Derroder of research suggests that after use of remifentanil hypersensitivity occurs mainly within 24h after surgery. As compared with the sufentanil, sufentanil on the inhibition of intraoperative stress and postoperative pain