摘要
目的:探讨妇科腹腔镜手术应用艾司氯胺酮对患者手术指标、疼痛情况、痛敏阈值、痛敏面积、舒芬太尼用量和安全性的影响。方法:选取本院2022年9月-2023年12月拟全身麻醉下行腹腔镜子宫病损切除术或腹腔镜卵巢病损切除术患者94例,随机数字表法分为常规组和观察组各47例,麻醉诱导前观察组注射艾司氯胺酮,常规组注射等量生理盐水。对比两组手术指标、术前术后静态和动态疼痛情况、术后切口和臂内侧的机械痛敏阈值、机械痛敏面积、术后舒芬太尼用量、不良反应。结果:观察组睁眼时间(12.11±1.38 min)和气管导管拔除时间(14.89±2.46 min)均低于常规组(13.24±1.69 min、16.03±2.51 min),术后静态和动态视觉模拟评分(1.57±0.87分、2.06±1.04分)均低于常规组(2.23±1.09分、2.74±1.18分),术后切口和臂内侧的机械痛敏阈值(52.03±8.29g、54.87±8.34g)高于观察组(40.56±7.62g、43.55±7.68g),切口和臂内侧机械痛敏面积(52.36±6.55 cm^(2)、50.21±6.94 cm^(2))低于常规对照组(64.18±7.69 cm^(2)、63.42±7.58 cm^(2)),舒芬太尼麻醉恢复室给药(17.16±2.31μg)、离开6h用量(19.24±3.10μg)和18h用量(16.13±2.57μg)均低于观察组(19.54±3.14μg、22.79±3.58μg、16.13±2.57μg),不良反应发生率(12.8%)低于常规组(34.0%)(均P<0.05)。结论:妇科腔镜手术中应用艾司氯胺酮可有效抑制患者术后痛觉过敏,改善手术恢复指标,不良反应降低,安全性较好。
Objective:To explore the effects of esketamine used during gynecological laparoscopic surgery of patients on their surgical indicators,pain situation,pain threshold,pain sensitive area,sufentanil dosage and safety.Methods:A total of 94 patients with lesions in uterus or ovarian who wanted laparoscopic lesions ectomy under general anesthesia were selected and were divided into two groups(47 patients in each group)according to random number table method from September 2022 to December 2023.The patients in the study group were injected with esketamine before anesthesia induction,and the patients in the control group were injected with the same amount of normal saline before anesthesia induction.The surgical indexes,the conditions of static and dynamic pain before and after operation,the pain sensitivity threshold and the area of the mechanical pain sensitivity of the incision,and the adverse reactions rate of the patients were compared between the two groups.Results:The eye opening time(12.11±1.38 min)and the tracheal tube removal time(14.89±2.46 min)of the patients in the study group were significantly lower than those(13.24±1.69min and 16.03±2.51 min)of the patients in the control group.The static and dynamic visual analogue scores(1.57±0.87 points and 2.06±1.04 points)of the patients in the study group were significantly lower than those(2.23±1.09points and 2.74±1.18 points)of the patients in the control group.The mechanical hyperalgesia thresholds of the incision and the medial arm(52.03±8.29g and 54.87±8.34g)of the patients in the study group were significantly higher than those(40.56±7.62g and 43.55±7.68g)of the patients in the control group.The mechanical hyperalgesia area of the incision and medial arm(52.36±6.55 cm^(2) and 50.21±6.94 cm^(2))in the study group were significantly lower than those(64.18±7.69 cm^(2) and 63.42±7.58 cm^(2))of the patients in the control group.The dosage of sufentanil used in postanesthesia care unit(PACU)(17.16±2.31μg),at 6h after discharge(19.24±3.10μg)and at
作者
季淼
邓雪峰
刘芹
张丁
尹莹莹
吴岩
JI Miao;DENG Xuefeng;LIU Qin;ZHANG Ding;YIN Yingying;WU Yan(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui Province,230031)
出处
《中国计划生育学杂志》
2024年第6期1345-1349,共5页
Chinese Journal of Family Planning
关键词
妇科腹腔镜手术
艾司氯胺酮
舒芬太尼
痛觉过敏
术后恢复
疼痛评分
不良反应
Gynecological laproscopic surgery
Esketamine
Sufentanil
Hyperalgesia
Postoperative recovery
Pain scores
Adverse reaction
