艾司氯胺酮注射液复合瑞芬太尼注射剂用于腹腔镜妇科手术患者的临床研究  

Clinical trial of esketamine injection combined with remifentanil injection in the treatment of patients undergoing laparoscopic gynecologic surgery

作　　者：刘锴锐 严北清 刘春梅 LIU Kai-rui;YAN Bei-qing;LIU Chun-mei(Department of Anesthesiology,Nantong Maternal and Child Health Hospital,Nantong 226000,Jiangsu Province,China)

机构地区：[1]南通市妇幼保健院麻醉科,江苏南通226000

出　　处：《中国临床药理学杂志》2023年第11期1547-1551,共5页The Chinese Journal of Clinical Pharmacology

基　　金：江苏省自然科学基金面上基金资助项目(BK20191207)。

摘　　要：目的观察艾司氯胺酮注射液复合瑞芬太尼注射剂用于腹腔镜妇科手术患者的临床疗效及安全性。方法将拟行腹腔镜妇科手术患者随机分为对照组和试验组。2组患者均行全麻。在此基础上,对照组给予1μg·kg^(-1)丙泊酚复合0.10μg·kg^(-1)瑞芬太尼维持麻醉;试验组给予0.5 mg·kg^(-1)艾司氯胺酮复合0.10μg·kg^(-1)瑞芬太尼维持麻醉。比较2组患者的心率(HR),平均动脉压(MAP),视觉疼痛模拟(VAS)评分,皮质醇(Cor)、前列腺素E2(PEG2)、神经元特异性烯醇化酶(NSE)和同型半胱氨酸水平(Hcy)水平,以及药物不良反应的发生情况。结果试验组入组63例,脱落1例,最终62例纳入分析;对照组入组63例,脱落2例,最终61例纳入分析。开始手术后25 min,试验组和对照组的心率分别为(96.75±9.73)和(113.65±10.48)beat·min^(-1),MAP分别为(94.12±8.74)和(103.79±8.65)mmHg,差异均有统计学意义(均P<0.05)。术后2 h,试验组和对照组的VAS评分分别为(2.27±0.46)和(3.18±1.16)分,Cor分别为(342.46±48.32)和(386.74±53.69)nmol·L^(-1),PEG2分别为(163.80±24.86)和(182.75±26.43)pg·mL^(-1),NSE分别为(30.16±4.09)和(38.67±5.93)μg·L^(-1),Hcy分别为(95.47±9.07)和(112.36±10.83)μg·L^(-1),差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应以恶心、呕吐和嗜睡为主,对照组发生的药物不良反应以恶心、呕吐和眩晕为主。试验组和对照组的总药物不良反应发生率分别为9.68%和6.56%,差异无统计学意义(P>0.05)。结论艾司氯胺酮注射液复合瑞芬太尼注射剂用于腹腔镜妇科手术患者可稳定术中血流动力学指标、减轻术后疼痛、抑制围术期应激反应,降低NSE、Hcy水平,且安全性良好。Objective To observe the clinical efficacy and safety of esketamine injection combined with remifentanil injection in the treatment of patients undergoing laparoscopic gynecologic surgery.Methods The patients undergoing laparoscopic gynecological surgery were randomly divided into control group and treatment group.Two groups received general anesthesia.On this basis,the control group was given 1μg·kg^(-1) propofol compound 0.10μg·kg^(-1) remifentanil for maintenance anesthesia;the treatment group was given 0.5 ng·kg^(-1) esketamine combined with 0.10μg·kg^(-1) remifentanil for maintained anesthesia.The heart rate(HR),mean arterial pressure(MAP),visual pain simulation(VAS)score,cortisol(Cor),prostaglandin E2(PEG2),neuron specific enolase(NSE)and homocysteine(Hcy)levels,and the adverse drug reactions were compared between the two groups.Results In treatment group,63 cases was enrolled,1 case was exfoliated,and finally 62 cases were included in the analysis.In the control group,63 cases were enrolled,2 cases were exfoliated,and 61 cases were included in the analysis.Twenty-five minutes after the operation,the HR of the treatment and control groups were(96.75±9.73)and(113.65±10.48)beat·min^(-1),the MAP were(94.12±8.74)and(103.79±8.65)mmHg,and the differences were statistically significant(all P<0.05).Two hours after operation,the VAS scores of the treatment and control groups were(2.27±0.46)and(3.18±1.16),the Cor levels were(342.46±48.32)and(386.74±53.69)nmol·L^(-1),the PEG2 levels were(163.80±24.86)and(182.75±26.43)pg·mL^(-1),the NSE levels were(30.16±4.09)and(38.67±5.93)μg·L^(-1),the Hcy levels were(95.47±9.07)and(112.36±10.83)μg·L^(-1),the differences were statistically significant(all P<0.05).The adverse drug reactions of treatment group were nausea,vomiting and lethargy,while those in the control group were nausea,vomiting and dizziness.The total incidences of adverse drug reactions in the treatment and control groups were 9.68%and 6.56%without significant difference(P>0.05).Conclusio

关 键 词：艾司氯胺注射剂 瑞芬太尼注射剂 腹腔镜妇科手术 血流动力学 术后痛觉过敏 安全性评价 

分 类 号：R971.2[医药卫生—药品]