盐酸艾司氯酸酮注射液联合脊神经后支阻滞应用于脊柱后路手术的临床效果  

Clinical effect of esketamine hydrochloride injection combined with posterior spinal nerve block in posterior spinal surgery

作　　者：肖琼瑶 张娇 李媛[1] XIAO Qiong-yao;ZHANG Jiao;LI Yuan(Department of Anesthesiology,First Affiliated Hospital of Hainan Medical College,Haikou Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院麻醉科,海南海口570102

出　　处：《局解手术学杂志》2021年第7期591-595,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：海南省自然科学基金青年基金项目(820QN397)。

摘　　要：目的探讨盐酸艾司氯酸酮注射液联合脊神经后支阻滞应用于脊柱后路手术的临床效果。方法选择64例行脊柱后路手术患者为研究对象,按照简单随机数字表法分为观察组和对照组,每组32例。对照组患者全身麻醉诱导前行脊神经后支阻滞,观察组患者在对照组基础上联合应用盐酸艾司氯酸酮注射液,2组患者术后均行自控镇痛泵镇痛。比较2组患者麻醉诱导前(T1)、术后2 h(T2)、术后12 h(T3)、术后24 h(T4)、术后48 h(T5)的视觉模拟量表(VAS)评分及血清促肾上腺皮质激素(ACTH)、皮质醇(Cor)、白介素-6(IL-6)、白介素-10(IL-10)水平,记录术后48 h内的不良反应情况。结果T1、T2时,2组患者VAS评分比较差异无统计学意义(P>0.05);T3~T5时,观察组患者VAS评分明显低于对照组(P<0.05)。T1、T4、T5时,2组患者血清ACTH、Cor、IL-6、IL-10水平比较差异无统计学意义(P>0.05);T2、T3时,观察组患者血清ACTH、Cor、IL-6水平明显低于对照组(P<0.05),而IL-10水平明显高于对照组(P<0.05)。观察组患者不良反应发生率明显低于对照组(P<0.05)。结论盐酸艾司氯酸酮注射液联合脊神经后支阻滞应用于脊柱后路手术能有效减轻患者术后疼痛,抑制应激反应,改善炎症因子水平,且不良反应少。Objective To investigate the clinical effect of esketamine hydrochloride injection combined with posterior spinal nerve block in posterior spinal surgery.Methods A total of 64 patients who underwent posterior spinal surgery were selected as the research objects,and they were divided into the observation group and the control group according to a simple random number table method,with 32 cases in each group.Patients in the control group received posterior spinal nerve block before induction of general anesthesia,and patients in the observation group were received esketamine hydrochloride injection on the basis of the control group.Patients in both the two groups received self-controlled analgesia pump analgesia after operation.The visual analogue scale(VAS)scores,the levels of serum adrenocorticotrophic hormone(ACTH),cortisol(Cor),interleukin-6(IL-6),and interleukin-10(IL-10)of the two groups before induction of anesthesia(T1),2 hours after surgery(T2),12 hours after surgery(T3),24 hours after surgery(T4),and 48 hours after surgery(T5)were compared.And the adverse reactions within 48 hours after surgery were recorded.Results At T1 and T2,there was no statistically significant difference in the VAS scores between the two groups(P>0.05).From T3 to T5,the VAS scores of patients in the observation group were significantly lower than those of patients in the control group(P<0.05).At T1,T4,and T5,there was no statistically significant difference in serum ACTH,Cor,IL-6,and IL-10 levels between the two groups(P>0.05).At T2 and T3,the serum ACTH,Cor,and IL-6 levels of patients in the observation group were significantly lower than those of patients in the control group(P<0.05),while the IL-10 level of patients in the observation group was significantly higher than that of patients in the control group(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Esketamine hydrochloride injection combined with posterior spinal nerve block appli

关 键 词：盐酸艾司氯酸酮注射液 脊神经后支阻滞 脊柱后路手术 术后疼痛 应激反应 白介素-6 白介素-10 

分 类 号：R614.2[医药卫生—麻醉学]