艾司氯胺酮在疼痛治疗中的应用进展  

Application Progress of (S)-ketamine in Pain Treatment

作　　者：任紫婷 陈文栋[1] 杨伟[1] REN Ziting;CHEN Wendong;YANG Wei(Department of Anesthesiology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院麻醉科,昆明650032

出　　处：《医学综述》2023年第19期3930-3935,3941,共7页Medical Recapitulate

基　　金：云南省卫生健康委员会医学后备人才培养计划(H-2019028)。

摘　　要：小剂量氯胺酮多被用于缓解慢性疼痛、预防痛觉敏化。与氯胺酮相比,艾司氯胺酮具有镇痛效果强、不良反应少、消除半衰期短等临床优点。艾司氯胺酮应用于术后镇痛不仅可作为阿片类药物镇痛的辅佐药物,还可减少阿片类不良反应发生,达到良好的镇痛效果,同时对慢性疼痛或周围神经损伤引起的神经性疼痛具有较好的缓解作用。在癌性镇痛中,应用艾司氯胺酮能减少患者难治性疼痛的发生并缓解抑郁焦虑情绪,明显提高晚期癌痛患者的生存质量。艾司氯胺酮的合理应用能更好地优化围手术期疼痛管理策略,为其在疼痛诊疗中的进一步临床应用提供参考。Low dose ketamine is mostly used to relieve chronic pain and prevent pain sensitization.Compared with ketamine,(S)-ketamine has the clinical advantages of strong analgesic effect,less adverse reactions,and short elimination half-life.(S)-ketamine for postoperative analgesia can not only be used as an auxiliary drug for opioid analgesia,but also reduce the adverse reactions of opioids to achieve good analgesic effect.At the same time,it has a good effect for alleviating chronic pain or neuropathic pain caused by peripheral nerve injury.In cancer pain relief,the use of(S)-ketamine can reduce the occurrence of refractory pain and relieve the depression and anxiety of the patients,and significantly improve the quality of life of the patients with advanced cancer pain.The rational application of(S)-ketamine can better optimize the perioperative pain management strategy,and provide reference for its further clinical application in pain diagnosis and treatment.

关 键 词：艾司氯胺酮 镇痛 痛觉过敏 N-甲基-D-天冬氨酸受体 

分 类 号：R971.1[医药卫生—药品]