Effects Of Remifentanil Gradual Withdrawal On Remifentanil Induced Postoperative Hyperalgesia During Breast Surgery

Objective: Remifentanil-induced hyperalgesia(RIH)has a serious impact on postoperative recovery and quality of life of patients,which has attracted extensive clinical attention.At present,there are some side effects of anti-hyperalgesia drugs,and the traditional methods of measuring pain,such as Visual Analog Scale(VAS),have obvious limitations.Therefore,in this study,Pain Vision pain quantification analyzer was used to evaluate RIH,and to observe the effect of remifentanil gradual withdrawal on the short-term occurrence of RIH after surgery.Methods: In this study,80 patients who were admitted to the First Affiliated Hospital of China Medical University from June to September 2020 and underwent elective simple resection of breast masses under general anesthesia were selected.By random number table method,they were divided into group A(abrupt withdrawal group,n=40)and group G(gradual withdrawal group,n=40).Current perception threshold(CPT)and pain threshold(PT)were measured by Pain Vision quantitative analyzer to determine the occurrence of hyperalgesia.Preoperative and postoperative CPT values,PT values,and VAS scores were recorded for 2h in 2 groups.Results: There were no significant differences in baseline data(gender,age,height,body weight,body mass index and history of hypertension)between 2 groups(all P>0.05).There were no significant differences in the preoperative CPT and PT values,as well as the PT values 2h after surgery between the two groups(all P>0.05).However,the PT value of group A with sudden drug withdrawal 2h after operation was significantly lower than that of group G with gradual drug withdrawal(P<0.01).There was no significant difference in VAS score 2h after surgery between 2 groups(P>0.05).In addition,there was no significant correlation between PT and VAS(Spearman correlation coefficient r =-0.209,P = 0.063).Conclusion: Gradual withdrawal of medication can alleviate postoperative hyperalgesia induced by continuous infusion of remifentanil in patients with breast mass resection alone and reduce adverse reactions.Compared with the VAS,the quantitative Pain Vision analyzer has important value in the evaluation of hyperalgesia after remifentanil surgery.