摘要
目的:探讨小剂量艾司氯胺酮对腹腔镜胆囊切除术(LC)患者全麻苏醒期躁动(EA)及炎症反应的影响。方法:选取110例行LC的患者为研究对象,按麻醉诱导前干预方式不同分为对照组与艾司氯胺酮组,每组各55例。艾司氯胺酮组患者麻醉诱导前给予小剂量(0.25 mg/kg)艾司氯胺酮注射干预;对照组患者给予与艾司氯胺酮等量的生理盐水注射干预。比较两组患者EA发生情况;术中麻醉药物用量;镇静(苏醒期Ramsay镇静评分)及疼痛[视觉模拟评分(VAS)]情况;入室时(T0)、术毕(T1)、拔管即刻(T2)及拔管后15 min(T3)血清白细胞介素6(IL-6)和IL-8水平;术后住院时间及不良反应发生情况。结果:艾司氯胺酮组患者EA发生率低于对照组(P<0.05),且躁动程度低于对照组(P<0.05);术中瑞芬太尼用量少于对照组(P<0.05);苏醒期Ramsay评分高于对照组(P<0.05);拔管后10 min VAS评分低于对照组(P<0.05);在T1、T2和T3时血清IL-6及IL-8水平低于对照组(P<0.05);术后住院时间短于对照组(P<0.05)。两组患者术后不良反应率无统计学差异(P>0.05)。结论:小剂量艾司氯胺酮能有效预防LC患者EA的发生,原因可能与减轻术后疼痛和抑制炎症反应有关。
Objective:To investigate the effects of low-dose esketamine on emergence agitation(EA)and inflammatory response in patients undergoing laparoscopic cholecystectomy(LC)during general anesthesia recovery period.Methods:A total of 110 patients undergoing LC were divided into control group and esketamine group according to the different ways of intervention,with 55 cases in each group.Before anesthesia induction,the esketamine group was injected with 0.25 mg/kg,while the control group was intravenously injected with the same amount of normal saline.The incidence of EA was compared between the two groups.The dosage of anesthetics during operation,Ramsay sedation score during recovery period and visual analogue scale(VAS)after extubation were recorded and compared between the two groups.The levels of serum interleukin-6(IL-6)and interleukin-8(IL-8)were measured at the time of entering the operating room(T0),at the end of operation(T1),at the time of extubation(T2)and 15 min after extubation(T3),and the hospitalization time and incidence of adverse reactions were compared between the two groups.Results:Compared with the control group,the incidence of EA in the esketamine group was decreased(P<0.05),and the severity of agitation was reduced(P<0.05).The dosage of remifentanil in the esketamine group was less than that in the control group(P<0.05),.the Ramsay score of the esketamine group during the recovery period was higher than that of the control group(P<0.05),and the VAS score decreased at 10 min after extubation was lower than that of the control group(P<0.05).Compared with the control group,at T1,T2 and T3,the serum levels of IL-6 and IL-8 in the esketamine group decreased(P<0.05).The postoperative hospital stay in the esketamine group was shorter comparing with the control group(P<0.05),and there was no significant difference in postoperative adverse reactions between the two groups(P>0.05).Conclusion:Low-dose esketamine can effectively prevent the occurrence of EA in LC patients,which may be related to reducing po
作者
闻萍
周先明
WEN Ping;ZHOU Xian-ming(Department of Anesthesiology,the People's Hospital of Chizhou,Chizhou 247000,Anhui,China;Department of Urology Surgery,the People's Hospital of Chizhou,Chizhou 247000,Anhui,China)
出处
《川北医学院学报》
CAS
2024年第7期920-923,共4页
Journal of North Sichuan Medical College
基金
安徽省卫生健康委科研项目(AHWJ2021b131)。
