Objective To investigate the effect of different doses of esketamine in preventing postoperative hyperalgesia in-duced by remifentanil.Methods A total of 120 patients who underwent elective laparoscopic surgery under general anesthesia in Department of Gynecology were enrolled and randomly divided into control group(group C),low-dose esketamine group(group L),and high-dose esketamine group(group H),with 40 patients in each group.At 5 minutes before anesthesia induction,the pa-tients in group L were given intravenous injection of esketamine 0.25 mg/kg,those in group H were given intravenous injection of esketamine 0.50 mg/kg,and those in group C were given intravenous injection of an equal volume of normal saline.The three groups were compared in terms of the indicators such as mechanical pain threshold and Visual Analogue Scale(VAS)score.Re-sults Compared with group C and group L,group H had significantly longer eye-opening time and extubation time(F=64.697,68.195,P＜0.05).Compared with group C,group L and group H had a significant increase in mechanical pain threshold around the non-dominant forearm and surgical incision at 2 and 18 hours after surgery(F=80.458-387.248,P＜0.05).Group C had a signifi-cant reduction in mechanical pain threshold around the non-dominant forearm and surgical incision from day 1 before surgery to 2 and 18 hours after surgery(F=2 615.864,P＜0.05).Compared with group C,group L and group H had a significant reduction in VAS score at 2 and 18 hours after surgery(H=53.736,42.971,P＜0.05).There were no significant differences between the three groups in the amount of remifentanil used during surgery,time of operation,postoperative salvage analgesia rate,and the incidence rate of adverse reactions(P＞0.05).Conclusion Intravenous injection of esketamine before anesthesia induction can alleviate postoperative hyperalgesia induced by remifentanil,and compared with the patients receiving 0.50 mg/kg esketamine,the patients receiving 0.25 mg/kg esketamine tend to have shorter eye-opening time and extubation time.
维普
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