单次静脉注射亚麻醉剂量氯胺酮对乳腺癌患者术后早期情绪的影响  

Effect of bolus subanesthetic dose ketamine on mood of patients with breast cancer during early period after operation

作　　者：周立旺[1] 毛华洁 周英[3] ZHOU Li-wang;MAO Hua-jie;ZHOU Ying(Department of Anesthesiology,Shaoxing Women&Children's Hospital,Shaoxing 312000,Zhejiang,China)

机构地区：[1]绍兴市妇幼保健院麻醉科,浙江绍兴312000 [2]宁波市鄞州区第二医院麻醉科,浙江宁波315040 [3]绍兴市妇幼保健院乳腺科,浙江绍兴312000

出　　处：《广东医学》2019年第23期3265-3268,共4页Guangdong Medical Journal

基　　金：浙江省医药卫生科技计划项目(编号:2017KY672)

摘　　要：目的观察单次静脉注射亚麻醉剂量氯胺酮对乳腺癌患者术后早期情绪的影响。方法选择行择期乳腺癌改良根治术患者80例,年龄45~66岁,体重45~75 kg,ASA分级Ⅰ~Ⅱ级。按随机数字表法分为氯胺酮组、对照组。每组40例。两组在相同全麻方案下完成手术,氯胺酮组术后镇痛采用单次静脉注射亚麻醉剂量氯胺酮+静脉镇痛泵,对照组术后镇痛采用单纯静脉镇痛泵。记录两组患者一般情况、术前及术后48 h患者焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、QoR-40调查问卷评分,记录两组患者术后6、12、24、48 h的VAS评分、Ramsay镇静评分及术后恶心呕吐、眩晕头痛等不良反应的发生情况。结果两组患者术前SAS评分、SDS评分、QoR-40调查问卷评分比较差异无统计学意义(P>0.05),术后6、12、24、48 h VAS评分,Ramsay镇静评分,术后不良反应发生率比较差异无统计学意义(P>0.05),术后48 h氯胺酮组患者SAS评分、SDS评分明显低于对照组,术后48 h氯胺酮组患者QoR-40评分明显高于对照组(P<0.05)。结论单次静脉注射亚麻醉剂量氯胺酮可明显改善乳腺癌患者术后早期情绪反应,有利于患者术后快速康复。Objective To observe the effect of bolus subanesthetic dose of ketamine on mood of patients with breast cancer during early period after operation. Methods Eighty patients received breast cancer surgery, who aged between 45 and 66 years, weighted between 45 and 75 kg and staged ASA Grade Ⅰ and Ⅱ, were divided into Group K(Ketamine group: intravenous ketamine + intravenous analgesia pump) and Group C(control group: intravenous analgesia pump alone), with 40 cases in each group. The general conditions of the two groups, SAS score, SDS score and QoR-40 questionnaire on the day before operation and 48 hours after operation were recorded. The VAS score and Ramsay sedation score 6, 12, 24 and 48 hours after operation were recorded. The complications during anesthesia and recovery were recorded.Results There was no significant difference in general condition, SAS score, SDS score, or QoR-40 questionnaire on the day before operation;in VAS score or Ramsay sedation score 6, 12, 24 and 48 hours after operation;nor in the incidence of adverse reactions between the two groups(P>0.05). The SAS score and SDS score in Group K were significantly lower than those in Group C 48 hours after operation, and the QoR-40 questionnaire in Group K group was significantly higher than that in Group C 48 hours after operation(P<0.05). Conclusion A bolus subanesthetic of ketamine can significantly improve the mood of patients with breast cancer during early period after operation, which is conducive to the rapid recovery of patients after operation.

关 键 词：氯胺飼 亚麻醉剂量 乳腺癌 情绪 

分 类 号：R614[医药卫生—麻醉学] R969[医药卫生—外科学]