目的:探讨右美托咪定对瑞芬太尼导致痛觉过敏的影响及其可能机制。方法:选择2018年7月至2019年7月在台州市中心医院行日间手术的80例患者（包括腹腔镜下胆囊切除、卵巢囊肿剥除患者），其中男46例，女34例，年龄（28.8±4.3）岁；依随机数字表法将患者分为右美托咪定组（麻醉诱导后在10 min内静脉输注右美托咪定1 μg/kg）、对照组（等量生理盐水静脉输注），每组各40例。记录两组患者的一般资料、术中资料，于术前和术后1、6及12 h评估患者的疼痛视觉模拟评分（VAS），并采用Von Frey纤毛法测定患者非手术部位的机械性痛阈，并在相应时间点抽取静脉血，以实时荧光定量PCR法测血液中微小RNA（miR）-183表达水平。对两组各指标进行比较分析。结果:两组基线资料比较，差异均无统计学意义（均n P>0.05）。在机械性痛阈阈值方面，右美托咪定组在术后1、6和12 h均高于对照组（均n P<0.05）。而VAS方面，右美托咪定组在术后1、6、12 h均低于对照组（均n P<0.05）。在血清miR-183水平上，右美托咪定组在术后1、6和12 h均高于对照组（2.07±0.41比1.68±0.60、1.99±0.33比1.74±0.54和1.88±0.36比1.67±0.54，均n P0.05）。n 结论:日间手术患者围手术期予以负荷量的右美托咪定可明显改善瑞芬太尼相关的痛觉过敏，其可能的作用与血液中miR-183的表达上调有关。“,”Objective:To investigate the effect of dexmedetomidine on remifentanil-induced hyperalgesia and its underlying mechanism through a prospective cohort study.Methods:From July 2018 to July 2019, 80 patients who underwent day surgery in Taizhou Central Hospital (including patients with laparoscopic cholecystectomy and oophorocystectomy) were selected, there were 46 males and 34 females with a mean age of (28.8±4.3) years. The patients were divided into dexmedetomidine group and control group with random number table, 40 cases in each group. After anesthesia induction, the dexmedetomidine group was managed with intravenous infusion of dexmedetomidine (1 μg/kg) within 10 minutes, while the control group was treated with an equal volume of normal saline. The patient′s general information and the intraoperative data were recorded. The visual analogue scale (VAS) was evaluated before the operation and 1, 6 and 12 h after the surgery. The Von Frey cilia method was conducted to determine the mechanical pain threshold of the patient′s non-surgical body parts. The vein blood was extracted at the corresponding time point to evaluate the expression level of miR-183 via the RT-PCR method. The demographic and preoperative parameters were comparable between the two groups.Results:Compared with the control group, the mechanical pain threshold in the dexmedetomidine group increased significantly at 1, 6, and 12 h after surgery (alln P<0.05), and the VAS score at the corresponding time point declined significantly (alln P<0.05). At the same time points, the serum miR-183 levels in the dexmedetomidine group were all significantly higher than those in the control group after surgery (2.07±0.41 vs 1.68±0.60, 1.99±0.33 vs 1.74±0.54, 1.88±0.36 vs 1.67±0.54, respectively, all n P<0.05).n Conclusion:A perioperative dose of dexmedetomidine in day surgery can significantly improve the remifentanil-related hyperalgesia, and it may be related to up-regulation of the expression of miR-183 in the blood.