艾司氯胺酮对乳腺癌病人的术后镇痛、炎症因子及早期情绪的影响  

Effect of the esketamine on postoperative analgesia,inflammatory factors and early mood in patients with breast cancer

作　　者：李菊[1] 刘明红 石军 孙杰[1] LI Ju;LIU Ming-hong;SHI Jun;SUN Jie(Department of Anesthesiology,The First Affiliated Hospital of Anhui University of Science and Technology,Huainan Anhui 232000,China)

机构地区：[1]安徽理工大学第一附属医院麻醉科,安徽淮南232000

出　　处：《蚌埠医学院学报》2022年第9期1188-1191,共4页Journal of Bengbu Medical College

基　　金：中国红十字基金会医学赋能公益专项基金(2022446)。

摘　　要：目的:探讨艾司氯胺酮对乳腺癌病人的术后镇痛、炎症因子及早期情绪的影响。方法:选择90例拟行乳腺癌根治手术的病人,随机分为观察组和对照组,各45例。2组均采用全身麻醉,术毕静脉自控镇痛泵,观察组舒芬太尼2μg/kg+艾司氯胺酮0.5 mg/kg+阿扎司琼20 mg,对照组舒芬太尼2μg/kg+阿扎司琼20 mg。比较2组病人术后视觉模拟评分法(VAS)评分、阿森斯失眠量表(AIS)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、不良反应发生率及血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平。结果:观察组T_(1)(术后6 h)、T_(2)(术后24 h)、T_(3)(术后48 h)时VAS评分均低于对照组(P<0.05~P<0.01)。T_(0)(术前24 h)时2组病人TNF-α、IL-6水平差异均无统计学意义(P>0.05),T_(1)、T_(2)时观察组TNF-α和IL-6水平均明显低于对照组(P<0.01)。T_(0)时2组AIS、SAS及SDS评分差异均无统计学意义(P>0.05),T_(2)、T_(3)时观察组AIS、SAS及SDS评分均低于对照组(P<0.05~P<0.01)。观察组术后补救镇痛发生率低于对照组(P<0.05),头晕发生率高于对照组(P<0.05)。结论:艾司氯胺酮用于乳腺癌根治术病人的术后镇痛,可以增强术后镇痛效果,减轻机体术后的炎症反应,明显改善病人睡眠质量,减少焦虑及抑郁情绪,提高病人康复质量。Objective:To investigate the effects of esketamine on the postoperative analgesia,inflammatory factors and early mood in patients with breast cancer.Methods:A total of 90 patients scheduled by radical mastectomy were randomly divided into the observation group and control group(45 cases in each group).Two groups were treated with general anesthesia,and the patient-controlled intravenous analgesia pump with 2μg/kg sufentanil,0.5 mg/kg esketamine combined with 20 mg azasetron and 2μg/kg sufentanil combined with 20 mg azasetron were implemented in the observation group and control group after operation,respectively.The visual analogue scale(VAS)score,Athens-insomnia scale(AIS)score,self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,incidence rate of adverse reactions and serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were compared between two groups.Results:The VAS scores in observation group at T_(1)(after 6 h of operation),T_(2)(after 24 h of operation)and T_(3)(after 48 h of operation)time points were significantly lower those that in control group(P<0.05 to P<0.01).There was no statistical significance in the serum levels of TNF-α and IL-6 between two groups at T_(0)(before 24 h of operation)(P>0.05),and the levels of TNF-α and IL-6 in observation group were significantly lower than those in control group at T_(1) and T_(2)(P<0.05).The differences of the scores of AIS,SAS and SDS between two groups at T_(0) were not statistically significant(P>0.05),and the scores of AIS,SAS and SDS in observation group at T_(2) and T_(3) were significantly lower than those in control group(P<0.05 to P<0.01).The incidence rate of postoperative analgesic rescue in observation group was significantly lower than that in control group(P<0.05),and the incidence rate of swirl in observation group was significantly higher than that in control group(P<0.05).Conclusions:The application of esketamine in postoperative analgesia of patients treated with radical mastectomy can enhance the p

关 键 词：术后镇痛 艾司氯胺酮 炎症细胞因子 失眠指数 焦虑 抑郁 

分 类 号：R614.2[医药卫生—麻醉学]