单次亚麻醉剂量氯胺酮对下颌角截骨术患者术后早期情绪反应的影响  

Effect of a single sub-anesthetic dose of ketamine on early emotion of patients having undertaken mandibular angle ostectomy

作　　者：汪婷婷 陈开文[1] 李建华[1] 胡惠英[1] 李斌[1] WANG Tingting;CHEN Kaiwen;LI Jianhua;HU Huiying;LI Bin(Department of Anesthesiology,the 161st Hospital of PLA,Wuhan 430010,China)

机构地区：[1]解放军第161医院麻醉科,武汉430010

出　　处：《实用医学杂志》2018年第15期2587-2589,2593,共4页The Journal of Practical Medicine

摘　　要：目的探讨单次亚麻醉剂量氯胺酮对下颌角截骨术患者术后早期情绪反应的影响。方法选择60例择期全麻下行下颌角截骨术患者,随机分为氯胺酮组(K组)和对照组(C组)。全麻诱导后K组于手术开始前5 min单次静注氯胺酮0.3 mg/kg,C组给予等容量生理盐水,术后两组患者均采用静脉镇痛。手术前1 d及术后48 h内使用医院焦虑抑郁量表(HAD)及QoR-40调查问卷对患者进行评估、拔管后30 min测定VAS及Ramsay评分,并记录麻醉结束至拔管的时间,有无呛咳、躁动、谵妄,拔管后30 min内不良反应发生情况。结果术后48 h K组HAD-A、HAD-D评分均低于C组(P<0.05);QoR-40总分无统计学差异(P>0.05),但K组术后48 h QoR-40情绪状态评分高于C组(P<0.05);K组拔管后30 min时VAS评分低于C组(P<0.05),Ramsay评分组间无统计学差异(P>0.05);拔管后不良反应发生率无统计学差异(P>0.05)。结论单次亚麻醉剂量氯胺酮可改善下颌角截骨术患者全麻术后早期焦虑/抑郁情绪反应,提高术后苏醒质量,不良反应少,有利于患者术后早期康复。Objective To investigate the effect of single sub-anesthetic on early emotion of patients having undertaken mandibular angle ostectomy(MAO).Methods Sixty patients scheduled for elective mandibular angle ostectomy were randomly divided into ketamine group(K group)and control group(C group).After induction of anesthesia,a single intravenous injection of 0.3 mg/kg ketamine was used in K group and in C group the same volume of saline was used 5 minutes before surgery.After MAO,intravenous analgesia was done in both the two group.The patients were assessed using the Hospital Anxiety and Depression Scale(HAD)and QoR-40 question-naire on the day before operation and 48 hours after operation.The visual analog scale(VAS)and Ramasay score were recorded 30 minutes after extubation.The complications during anesthesia and recovery such as cough,agita-tion,dizziness were recorded.Results The HAD-A and HAD-D scores of K group 48h after operation,were sig-nificantly lower than C group(P<0.05).The difference in QoR-40 score between two groups was no significant(P>0.05).The emotional state QoR-40 score of K group was significantly higher than C group(P<0.05).The VAS scores 30 minutes after extubation of K group were lower than C group(P<0.05).There was no significant difference in Sedation score(P>0.05).No significant differences were founded in the noted extubation time between the two groups.Conclusion A single sub-anesthetic dose of ketamine can reduce postoperative anxiety and depression and improve quality of recovery without an increase of adverse events in patients having undertaken mandibular angle ostectomy.

关 键 词：氯胺酮 亚麻醉剂量 截骨术 抑郁/焦虑 

分 类 号：R614[医药卫生—麻醉学]