0.2mg/kg剂量艾司氯胺酮对宫腔镜手术麻醉诱导期间血流动力学影响  

Effects of 0.2mg/kg of esketamine for anesthesia induction during hysteroscopic surgery of women on their haemodynamics

作　　者：刘袁静[1] 王健[1] 陈静[1] 鞠学军[1] LIU Yuanjing;WANG Jian;CHEN Jing;JU Xuejun(Nanjing Tongren Hospital,Affiliated to Southeast University Medical College,Nanjing,Jiangsu Province,21110)

机构地区：[1]东南大学医学院附属南京同仁医院,211102

出　　处：《中国计划生育学杂志》2022年第10期2243-2247,共5页Chinese Journal of Family Planning

摘　　要：目的:探究亚麻醉剂量艾司氯胺酮对宫腔镜手术麻醉诱导期间血流动力学影响.方法:选取2021年6月-2022年3月本院妇产科收治的宫腔镜手术患者82例,随机分为观察组和对照组各41例,均采用舒芬太尼0.1μg/kg和依托咪酯0.2mg/kg麻醉诱导,观察组在上述麻醉诱导前加用0.2mg/kg艾司氯胺酮,对照组应用0.2mg/kg氯化钠溶液.统计两组麻醉不同时点心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压、血氧饱和度(SpO_(2)),血糖和动脉乳酸水平,比较麻醉效果与不良反应.结果:HR、SBP、DBP、SpO_(2)水平,麻醉诱导前(T_(1))和苏醒后即刻(T_(4))两组未见差异,进镜前即刻(T_(2))和检查终点时(T_(3))观察组均高于对照组(均P<0.05);血浆肾上腺素和去甲肾上腺素水平,在各个观察时点两组均无差异(P>0.05),组内比较T_(2)和T_(3)两组均高于T_(1)时本组(P<0.05),T_(4)与T_(1)时组内无差异(P>0.05).两组在麻醉诱导后血糖上升、乳酸下降,且观察组诱导后血糖低于对照组(P<0.05).麻醉有效率观察组(100%)高于对照组(87.8%)(P<0.05),不良反应总发生(2.4%、7.3%)无差异(P>0.05).结论:应用0.2mg/kg剂量艾司氯胺酮有助于宫腔镜手术中患者的血流动力学稳定,麻醉效果良好,且安全可靠.Objective: To investigate the effects of sub-anesthetic dose of esketamine for anesthesia induction during hysteroscopic surgery of women on their haemodynamics.Methods:A total of 82 women who wanted hysteroscopic surgery were selected and were randomly divided into two groups(41 cases in each group)from June 2021 to March 2022.The women in both groups were given anesthesia induction by sufentanil 0.1μg/kg and etomidate 0.2mg/kg.The women in the observation group were given 0.2mg/kg esketamine additionally,while the women in the control group were given 0.2mg/kg sodium chloride solution additionally.The values of heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure,and blood oxygen saturation(SpO_(2)),and the levels of blood glucose and arterial lactic acid of the women in the two groups were counted.The anesthetic effect and adverse reactions rate of the women were compared between the two groups.Results:The values of HR,SBP,DBP,and SpO_(2) of the women before induction of anesthesia(T_(1))and immediately after awakening(T_(4))had no significantly different between the two groups,but which of the women in the observation group immediately before entry laryngoscope(T_(2))and at the end of examination(T_(3))were significantly higher than those of the women in the control group(all P<0.05).There were no significant differences in the levels of epinephrine and norepinephrine of the women at each test point between the two groups(P>0.05).The levels of epinephrine and norepinephrine of the women in the two groups at T_(2) and T_(3) were significantly higher than those at T_(1)(P<0.05),and which of the women in the two groups had no significant difference between at T_(4) and at T_(1)(P>0.05).The blood glucose level of the women in the two groups after induction of anesthesia had increased significantly,and which of the women in the observation group was significantly lower than that of the women in the control group.The lactic acid level of the women in the two groups had d

关 键 词：宫腔镜 麻醉诱导 亚麻醉剂量艾司氯胺酮 血流动力学 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]