小剂量艾司氯胺酮对经鼻蝶入路垂体瘤切除术患者术后苏醒质量的影响  

Effect of low-dose esketamine on the quality of recovery from anesthesia in patients undergoing transnasal transsphenoidal pituitary tumor resection

作　　者：陈婷 廖兴志[2] 刘宇芳[2] 胡锐 周洹竹 李佳英 周脉涛 CHEN Ting;LIAO Xingzhi;LIU Yufang;HU Rui;ZHOU Huanzhu;LI Jiaying;ZHOU Maitao(School of Anesthesiology,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;The 904 Hospital of the Joint Service Support Force of the People's Liberation Army,Wuxi,Jiangsu 214000)

机构地区：[1]徐州医科大学麻醉学院,江苏徐州221004 [2]中国人民解放军联勤保障部队第904医院,江苏无锡214000

出　　处：《徐州医科大学学报》2022年第10期737-741,共5页Journal of Xuzhou Medical University

基　　金：无锡市科技局面上项目(Y20212046)。

摘　　要：目的评估小剂量艾司氯胺酮对经鼻蝶入路垂体瘤切除术患者术后苏醒质量的影响。方法选择行经鼻蝶入路垂体瘤切除术患者60例,随机分为艾司氯胺酮组(n=30)、对照组(n=30)。艾司氯胺酮组麻醉诱导后静脉注射0.15 mg/kg艾司氯胺酮并泵注(5μg·kg^(-1)·min^(-1))至术毕前15 min,对照组按同样方法输注等量生理盐水。评估2组患者术后苏醒期呛咳发生率和严重程度、Ricker镇静-躁动评分(SAS)和躁动发生率、疼痛视觉模拟评分(VAS)和补救镇痛发生率等苏醒质量指标。结果与对照组比较,艾司氯胺酮组的呛咳发生率和严重程度降低(P<0.05),SAS评分、VAS评分和补救镇痛率降低(P<0.05),2组躁动发生率差异无统计学意义(P>0.05);艾司氯胺酮组拔管期血流动力学更加稳定(P<0.05),2组的睁眼时间、拔管时间和不良反应发生情况差异无统计学意义(P>0.05)。结论术中持续使用小剂量艾司氯胺酮可降低经鼻蝶入路垂体瘤切除术患者苏醒期呛咳发生率及严重程度,减轻术后疼痛,且不增加患者不良反应,有利于提高患者的苏醒质量。Objective To evaluate the effect of low-dose esketamine on the quality of recovery from anesthesia in patients undergoing transnasal transsphenoidal pituitary tumor resection.Methods A total of 60 patients who were scheduled for transnasal transsphenoidal pituitary tumor resection were enrolled.They were randomly divided into two groups(n=30):an esketamine group(group R)and a control group(group S).After anesthesia induction,group R was intravenously administered with 0.15 mg/kg esketamine followed by pumping at a rate of 5μg·kg^(-1)·min^(-1) until 15 min before the end of operation.Meanwhile,group S was administered with normal saline.The incidence and severity of coughing during the recovery period,Ricker sedation agitation score(SAS),agitation incidence,VAS score,and rescue analgesia rate were recorded.Results Compared with group S,group R showed remarkable decreases in the incidence and severity of coughing,and reduction in SAS scores,VAS scores and rescue analgesia rate(P<0.05).There was no statistical difference in agitation incidence(P>0.05).The hemodynamics in group R during extubation were more stable lower than those in group S(P<0.05).There was no significant difference in eye-opening time,extubation time and adverse event incidence between the two groups(P>0.05).Conclusions During transnasal transsphenoidal pituitary tumor resection,continuous infusion of low dose esketamine can reduce the incidence and severity of coughing,reduce postoperative pain,and does not increase adverse reactions,which is beneficial to improve the quality of recovery from anesthesia.

关 键 词：艾司氯胺酮 垂体瘤切除术 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]