不同剂量艾司氯胺酮对腹腔镜子宫切除术患者术后恢复质量的影响  

Effect of different doses of esketamine on postoperative recovery quality in patients undergoing laparoscopic hysterectomy

作　　者：刘海艳[1] 陈秀侠 岳耀存 赵英花 李爱梅[1] Liu Haiyan;Chen Xiuxia;Yue Yaocun;Zhao Yinghua;Li Aimei(Department of Anesthesiology,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Anesthesiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China)

机构地区：[1]济宁医学院附属医院麻醉科,济宁272029 [2]徐州医科大学附属医院麻醉科,徐州221002

出　　处：《国际麻醉学与复苏杂志》2023年第7期720-725,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨不同剂量艾司氯胺酮对腹腔镜子宫切除术患者术后早期恢复质量的影响。方法纳入2021年10月至2022年3月行腹腔镜子宫切除术的患者105例,采用随机数字表法将患者分为3组(每组35例):艾司氯胺酮0.3 mg/kg组(L组)、艾司氯胺酮0.5 mg/kg组(H组)和对照组(C组)。L组静脉注射艾司氯胺酮0.3 mg/kg,H组静脉注射艾司氯胺酮0.5 mg/kg,C组给予体积的生理盐水。记录3组患者一般资料及手术时间、麻醉时间和拔管时间;记录3组患者术前第1天、术后第1天、术后第2天的40项恢复质量量表(40‑item Quality of Recovery Scale,QoR‑40)评分(包括总分以及身体舒适度、情绪状态、自理能力、心理支持、疼痛5个维度评分)、状态焦虑(State Anxiety Inventory,SAI)评分和蒙哥马利⁃艾森贝格抑郁评定量表(Montgomery‑Asberg Depression Rating Scale,MADRS)评分;记录3组患者术后30 min、2 h、12 h、24 h的数字分级评分法(Numerical Rating Scale,NRS)评分以及术后不良事件发生率。结果3组患者术前第1天QoR‑40评分(总分以及身体舒适度、情绪状态、自理能力、心理支持、疼痛评分)、SAI评分和MADRS评分差异无统计学意义(P>0.05)。与术前第1天比较:3组患者术后第1天QoR‑40评分总分以及身体舒适度、情绪状态、自理能力、疼痛评分均降低(P<0.05);C组患者术后第1天和术后第2天MADRS评分升高(P<0.05),术后第2天QoR‑40评分总分以及身体舒适度、情绪状态、自理能力、疼痛评分降低(P<0.05),SAI评分降低(P<0.05);L组和H组患者术后第1天SAI评分降低(P<0.05),MADRS评分升高(P<0.05),术后第2天QoR‑40评分总分以及身体舒适度、自理能力评分降低(P<0.05),SAI评分降低(P<0.05);L组患者术后第2天QoR‑40评分的情绪状态和疼痛评分降低(P<0.05)。与C组比较:L组和H组患者术后第1天和术后第2天QoR‑40评分总分以及身体舒适度、情绪状态、疼痛评分升高(P<0.05),SAI评分�Objective To investigate the effect of different doses of esketamine on the quality of early recovery in patients after laparoscopic hysterectomy.Methods A total of 105 patients who underwent laparoscopic hysterectomy from October 2021 to March 2022 were enrolled.According to the random number table method,the patients were divided into three groups(n=35):an esketamine 0.3 mg/kg group(group L),an esketamine 0.5 mg/kg group(group H)and a control group(group C).Group L and group H were given intravenous injection of esketamine 0.3 mg/kg and 0.5 mg/kg,and group C was given intravenous injection of normal saline solution in a similar volume.Their general information,the duration of operation,anesthesia time and extubation time were recorded.The 40‑item Quality of Recovery Scale(QoR‑40)scores(QoR‑40 total scores as well as the scores of physical comfort,emotional state,self‑care ability,psychological support,and pain),the State Anxiety Inventory(SAI)score and the Montgomery‑Asberg Depression Rating Scale(MADRS)score were recorded on preoperative day 1,and postoperative days 1 and 2.The Numerical Rating Scale(NRS)scores were evaluated at postoperative 30 min,2 h,12 h and 24 h and the incidence of postoperative adverse events were also recorded.Results There was no significant difference in QoR‑40 total scores as well as the scores of physical comfort,emotional state,self‑care ability,psychological support and pain,SAI and MADRS scores among the three groups on preoperative day 1(P>0.05).Compared with those on preoperative day 1,QoR‑40 total scores and the scores of physical comfort,emotional state,self‑care ability and pain in the three groups decreased on postoperative day 1(P<0.05);while the MADRS scores increased on postoperative days 1 and 2(P<0.05),and QoR‑40 total scores as well as the scores of physical comfort,emotional state,self‑care ability and pain,and SAI scores in group C decreased on postoperative day 2(P<0.05).In group L and group H,SAI scores showed decreases and MADRS scores show

关 键 词：艾司氯胺酮 子宫切除术 恢复质量 焦虑 抑郁 

分 类 号：R614[医药卫生—麻醉学]