Article(id=1291704834168738320, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.18.007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1748880000000, receivedDateStr=2025-06-03, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896031181, onlineDateStr=2026-08-05, pubDate=1758988800000, pubDateStr=2025-09-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896031181, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896031181, creator=13701087609, updateTime=1785896031181, updator=13701087609, issue=Issue{id=1291704811443999077, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='18', pageStart='2551', pageEnd='2700', issueExtLink='null', onlineDate='null', pubDate='1758988800000', pubDateStr='2025-09-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896025763, creator='13701087609', updateTime=1785896871490, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291708358743053253, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291708358743053254, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2611, endPage=2617, ext={EN=ArticleExt(id=1291704834617528849, articleId=1291704834168738320, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical study on the effects of different doses of alfentanil on patients undergoing laparoscopic cholecystectomy, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the effects and safety of different doses of alfentanil injection on hyperalgesia after continuous infusion of remifentanil injection in patients undergoing laparoscopic cholecystectomy.
Method The patients scheduled to undergo laparoscopic cholecystectomy were divided into group A, group B, group C and group D. Ten minutes before the end of the surgery, groups A, B and C were intravenously injected with alfentanil at doses of 5, 15 and 25 μg·kg-1, respectively, while group D was injected with 0.9% NaCl. The hemodynamics indices [before anesthesia induction (T0), 5 minutes after induction (T1), during intubation (T2), at skin incision (T3), during extubation (T4), 10 minutes after extubation (T5)], quality of awakening, analgesia and sedation scores, incidence of postoperative hyperalgesia, inflammatory factors and safety were compared among the 4 groups.
Results A total of 42 patients in each group were included in the statistical analysis. At T4, mean arterial pressure (MAP) values in groups A, B, C and D were (92.81±10.31), (87.50±10.33), (85.60±9.69) and (98.48±7.07) mmHg, respectively; heart rate (HR) values were (87.36±9.25), (81.76±9.35), (80.24±9.38) and (92.83±9.73) beat·min-1, respectively; at T5, MAP values were (95.40±8.63), (90.19±8.79), (89.71±8.86) and (99.48±8.72) mmHg, respectively; HR values were (92.31±8.56), (87.55±8.84), (86.24±8.64) and (97.33±8.51) beat·min-1, respectively; extubation time were (9.07±1.02), (9.38±1.25), (11.48±1.58) and (10.74±1.38) min; spontaneous breathing recovery time were (6.52±1.27), (6.86±1.28), (8.38±1.53) and (7.29±1.13) min; and PACU stay time were (22.64±4.57), (23.69±4.25), (32.95±4.62) and (27.26±4.98) min for groups A, B, C, and D, respectively; the incidence of hyperalgesia at 2 h postoperation were 4.76% (2 cases/42 cases), 2.38% (1 cases/42 cases), 0 and 21.43% (9 cases/42 cases), and at 24 h postoperation were 9.52% (4 cases/42 cases), 4.76% (2 cases/42 cases), 0 and 23.81% (10 cases/42 cases) in groups A, B, C, and D, respectively. Differences between group D and the other three groups were statistically significant (all P<0.05). There were no obvious adverse drug reactions in groups A and D. Adverse drug reactions in group B included nausea and vomiting, and adverse drug reactions in group C included respiratory depression. The total adverse drug reactions in groups A, B, C, and D were 0% (0 cases/42 cases), 2.38% (1 case/42 cases), 4.76% (2 cases/42 cases), and 0% (0 cases/42 cases), respectively, and there were no statistically significant differences (all P>0.05).
Conclusion Compared with low dose alfentanil injection, high dose alfentanil injection applied in cholecystectomy can reduce hyperalgesia, effectively relieve pain, and alleviate inflammatory response, but the effect on improving the recovery quality of patients is not obvious.
, authors=Xiao-qun WANG, Wen-jing NI, Guang-wei ZHOU, Man-he ZHANG, authorsList=Xiao-qun WANG, Wen-jing NI, Guang-wei ZHOU, Man-he ZHANG, authorCompany=null, correspAuthors=Man-he ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291704835338949138, articleId=1291704834168738320, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=不同剂量阿芬太尼对腹腔镜胆囊切除术患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察不同剂量阿芬太尼注射液应用于腹腔镜胆囊切除术患者瑞芬太尼注射液持续输注后痛觉过敏的临床疗效和安全性。
方法 将拟行腹腔镜胆囊切除术的患者分为A组、B组、C组和D组。在手术结束前10 min，A组、B组、C组分别静脉注射阿芬太尼5、15和25 μg·kg-1，D组注射0.9%NaCl。比较4组患者麻醉诱导前（T0）、诱导后5 min（T1）、插管时（T2）、切皮时（T3）、拔管时（T4）和拔管后10 min（T5）的血流动力学指标、苏醒质量、镇痛与镇静评分、术后痛觉过敏发生率和炎症因子，并进行安全性评价。
结果 A组、B组、C组和D组最终均有42例纳入统计分析。T4时，A组、B组、C组和D组的平均动脉压（MAP）分别为（92.81±10.31）、（87.50±10.33）、（85.60±9.69）及（98.48±7.07）mmHg，心率（HR）分别为（87.36±9.25）、（81.76±9.35）、（80.24±9.38）及（92.83±9.73）beat·min-1；T5时，A组、B组、C组和D组MAP分别为（95.40±8.63）、（90.19±8.79）、（89.71±8.86）及（99.48±8.72）mmHg，HR分别为（92.31±8.56）、（87.55±8.84）、（86.24±8.64）及（97.33±8.51）beat·min-1。A组、B组、C组和D组拔管时间分别为（9.07±1.02）、（9.38±1.25）、（11.48±1.58）及（10.74±1.38）min，A组、B组、C组和D组自主呼吸恢复时间分别为（6.52±1.27）、（6.86±1.28）、（8.38±1.53）及（7.29±1.13）min，A组、B组、C组和D组麻醉后监测治疗室（PACU）停留时间分别为（22.64±4.57）、（23.69±4.25）、（32.95±4.62）及（27.26±4.98）min。术后2 h，A组、B组、C组、D组痛觉过敏发生率分别为4.76%（2例/42例）、2.38%（1例/42例）、0及21.43%（9例/42例）；术后24 h，A组、B组、C组、D组痛觉过敏发生率分别为9.52%（4例/42例）、4.76%（2例/42例）、0及23.81%（10例/42例），D组上述指标与A组、B组和C组比较，在统计学上差异均有统计学意义（均P<0.05）。A组和D组未见明显药物不良反应，B组药物不良反应有恶心呕吐，C组药物不良反应有呼吸抑制，A组、B组、C组和D组总药物不良反应分别为0、2.38%（1例/42例）、4.76%（2例/42例）及0，在统计学上差异均无统计学意义（均P>0.05）。
结论 相较于低剂量阿芬太尼注射液，高剂量阿芬太尼注射液应用于胆囊切除术中，可减轻患者痛觉过敏，有效镇痛，缓解炎症反应，但对患者苏醒质量改善效果不明显。
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王晓群（1988-），女，主治医师，主要从事临床麻醉及围术期器官保护方向的工作和研究
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