艾司氯氨酮预处理对乳腺肿瘤手术患者术后睡眠质量及心理状态的影响  

Effects of S-Ketamine pretreatment on postoperative sleep quality and psychological state of patients undergoing breast cancer surgery

作　　者：李敏[1] 冯涛 余向天 梅玫[1] 代文涛[1] 梁启胜[1] Li Min;Feng Tao;Yu Xiangtian;Mei Mei;Dai Wentao;Liang Qisheng(The first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2023年第8期794-797,共4页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学类项目(2021byzd127)。

摘　　要：目的探讨低剂量艾司氯胺酮预处理对乳腺癌改良根治手术患者术后睡眠质量及心理状态的影响。方法选择2022年1—10月本院收治的80例行乳腺癌改良根治手术的患者作为研究对象,年龄18-65岁,ASA分级为Ⅰ-Ⅲ级。将患者随机分为艾司氯胺酮组(A组)和对照组(C组)两组,每组各40例。A组术毕前30 min给与0.2 mg/kg艾司氯胺酮;C组术毕前30 min给与生理盐水。比较术前和术后24 h、48 h的匹兹堡睡眠质量指数(PSQI)及汉密顿抑郁量表17项(HAMD-17)评分;比较苏醒时间、拔管后患者Ramsay镇静评分、PACU停留时间和疼痛视觉模拟评分(VAS);记录患者术后补救镇痛发生率;记录恶心呕吐及噩梦幻觉等不良反应发生情况。结果与C组相比较,A组术后24 h、48 h的睡眠质量指数和HAMD-17评分显著降低(P<0.05)。A组在术后PACU及术后24 h的疼痛模拟评分、补救镇痛率均低于对照组(P<0.05)。其他术后不良反应发生情况比较,差异无统计学意义(P>0.05)。结论低剂量艾司氯胺酮预处理能改善乳腺癌患者术后早期的睡眠质量和抑郁-焦虑评分,减轻术后疼痛,提高苏醒质量。Objective To investigate the effect of low-dose S-Ketamine pretreatment on postoperative sleep quality and psychological state of patients undergoing modified radical mastectomy.Methods 80 patients underwent modified radical mastectomy in our hospital from January 2022 to October 2022 were enrolled as study subjects,aged 18-65 years,ASA gradingⅠ-Ⅲ.Patients were randomly divided into S-Ketamine group(Group A)and control group(group C),with 40 cases in each group.Group A was given S-Ketamine at the dose of 0.2 mg/kg at 30min before the completion of surgery,and Group C was injected with saline at 30min before the completion of surgery.Pittsburgh sleep quality index(PSQI)and HAMD-17 score were measured before operation,and at 24h and 48h after surgery.Recovery time,Ramsay sedation score after extubation,PACU residence time and visual analog scale of pain(VAS)were compared between two groups.The incidence of remedial analgesia were recorded after surgery.Postoperative adverse reactions such as nausea,vomiting,nightmares and hallucinations were recorded.Results Compared with group C,the sleep quality index and HAMD-17 score of group A were significantly decreased at 24 h and 48 h after surgery(P<0.05).Postoperative PACU,24h postoperative VAS scores,and incidence of remedial analgesia in group A were lower than that in group C(P<0.05).There was no significant difference in the occurrence of other postoperative adverse reactions between the two groups(P>0.05).Conclusions Low dose S-Ketamine pretreatment can improve sleep quality and depression-anxiety score,reduce postoperative pain and improve the quality of recovery of patients underwent modified radical mastectomy.

关 键 词：艾司氯胺酮 乳腺癌改良根治手术 睡眠质量 术后焦虑 抑郁 心理状态 

分 类 号：R614[医药卫生—麻醉学]