Intraoperative Nalmefene Reduces Remifentanil-induced Postoperative Hyperalgesia

Xiaoying YAN; Shimei LI; Haixia JIANG

doi:10.12259/j.issn.2095-610X.S20230118

Volume 44 Issue 1

Jan. 2023

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Xiaoying YAN, Shimei LI, Haixia JIANG. Intraoperative Nalmefene Reduces Remifentanil-induced Postoperative Hyperalgesia[J]. Journal of Kunming Medical University, 2023, 44(1): 59-64. doi: 10.12259/j.issn.2095-610X.S20230118

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Intraoperative Nalmefene Reduces Remifentanil-induced Postoperative Hyperalgesia

doi: 10.12259/j.issn.2095-610X.S20230118

1.
Dept. of Anesthesiology，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Dept. of Anesthesiology，Kunming Xishan District People’s Hospital， Kunming Yunnan 650100，China

Received Date: 2022-10-19
Publish Date: 2023-01-25

Abstract

Abstract

Objective Intraoperative use of a high-dose remifentanil may induce postoperative hyperalgesia. This paper aims to investigate whether low-dose nalmefene can prevent the postoperative hyperalgesia induced by high-dose remifentanil. Methods Ninety patients undergoing thyroidectomy were randomly assigned into 3 groups with 0.1 ug/kg/min of remifentanil （LR）, 0.3 μg/kg/min of remifentanil （HR）, 0.3 μg/kg/min of remifentanil with 0.1 μg/kg/h nalmefene （HR+LN） in each group. The pain thresholds to mechanical stimuli were measured by using von frey filaments on the peri-incision area 24 h and 48 h after the surgery. Also the pain intensity, additional analgesics consumption and adverse events up to 48 h were measured after the surgery. Results The pain threshold on the peri-incision area was significantly lower in the HR group at 24 h after the surgery than the preoperative baseline （P = 0.002）. Furthermore, it was decreased in the HR group compared with the LR （P = 0.022） and HR+LN （P = 0.03） groups at 24 h after the surgery. The pain threshold on the peri-incision area still significantly decreased in the HR group at 48 h after surgery compared with the preoperative baseline （P = 0.017）. Furthermore, it was also decreased in the HR group compared with the LR （P = 0.016） and HR+LN （P = 0.02） groups at 48 h after the surgery. Postoperative pain intensity presented as NRS scores were significantly higher in the HR group than in the LR at 6 h （ P = 0.01）, 24 h （P = 0.007） and HR+LN at 6 h （ P = 0.038）, 24 h （P = 0.02） groups after the surgery. The number of patients who requested additional analgesics at 6 h after surgery was significantly higher in the HR group than in the other groups （P < 0.05）. Postoperative adverse events were similar between groups. Conclusion Low dose nalmefene can prevent the postoperative hyperalgesia induced by high-dose remifentanil in patients undergoing thyroidectomy.
- Remifentanil,
- Hyperalgesia,
- Nalmefene

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References

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