艾司氯胺酮对全麻下行乳腺癌根治术患者术后睡眠及恢复的影响  

Effects of esketamine on sleep and recovery of patients after radical mastectomy under general anesthesia

作　　者：周艳鸿 谭其莲 张勇[2] 陶婷[3] Zhou Yanhong;Tan Qilian;Zhang Yong;Tao Ting(Department of Anesthesiology,Nanjing Yuhua Hospital,Yuhua Branch of Nanjing First Hospital,Nanjing 210000,China;Department of Anesthesiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Pharmacy,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京市雨花医院(南京市第一医院雨花分院)麻醉科,江苏南京210000 [2]南京医科大学附属南京医院(南京市第一医院)麻醉科,江苏南京210006 [3]南京医科大学附属南京医院(南京市第一医院)药学部,江苏南京210006

出　　处：《实用药物与临床》2024年第1期26-30,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的 观察术中使用艾司氯胺酮对全麻下乳腺癌根治术患者术后睡眠及恢复的影响。方法 选择2022年7月至2023年3月南京市第一医院、南京市第一医院雨花分院(雨花医院)择期全麻下行乳腺癌根治术的患者80例,随机分为对照组和艾司氯胺酮组。艾司氯胺酮组患者在术中持续输注0.3 mg/(kg·h)的艾司氯胺酮,对照组患者术中持续输注等量的生理盐水。记录两组患者术前1 d及术后第1、3天术后睡眠功能障碍的发生情况及睡眠时间,并在同一时间点行Christensen疲劳评分及焦虑和抑郁评分;在术后第1、3天记录15项恢复质量评分(QoR-15);记录两组患者手术时间、患者麻醉恢复室(PACU)时间、术后24 h视觉模拟评分(VAS)评分及术后不良反应发生率。结果 艾司氯胺酮组患者术后第1、3天,睡眠功能障碍的发生率低于对照组(P<0.05),睡眠时间长于对照组(P<0.05);术后第1、3天,艾司氯胺酮组Christensen疲劳评分低于对照组(P<0.05),术后恢复质量评分高于对照组(P<0.05);艾司氯胺酮组术后24 h VAS评分低于对照组(P<0.05);两组患者手术时间、PACU时间、术后焦虑和抑郁评分及术后不良反应发生率比较差异无统计学意义(P>0.05)。结论 乳腺癌根治术中使用艾司氯胺酮可以改善患者术后睡眠及疲劳,促进术后恢复。Objective To observe the effect of esketamine on sleep and recovery of patients after radical mastectomy under general anesthesia.Methods Totally 80 patients undergoing radical mastectomy under general anesthesia in Nanjing First Hospital and Yuhua Branch of Nanjing First Hospital(Yuhua Hospital)from July 2022 to March 2023 were chosen and randomly divided into two groups.Patients in esketamine group received continuous infusion of esketamine 0.3 mg/(kg·h)intraoperatively,and patients in control group continued to receive the same amount of normal saline during operation.The occurrence of postoperative sleep dysfunction and sleep time in the two groups were recorded 1 d before surgery and on the first and third day after operation,and the Christensen fatigue score and anxiety and depression score were recorded at the same time point;the fifteen recovery quality scores(QoR-15)were recorded on the first and third day after operation.The operation time,PACU time,VAS score at 24 h after operation and the incidence of postoperative adverse reactions were recorded.Results On the first and third day after operation,the incidence of postoperative sleep dysfunction in esketamine group was lower than that in control group(P<0.05),while the sleep time was longer(P<0.05).The Christensen fatigue score in esketamine group was lower than that in control group(P<0.05)on the first and third day after operation,while the quality of postoperative recovery was higher(P<0.05).The VAS score in esketamine group at 24 h after surgery was lower than that in control group(P<0.05).There was no significant difference in operation time,PACU time,postoperative anxiety and depression scores,or the incidence of postoperative adverse reactions between the two groups(P>0.05).Conclusion The use of esketamine in radical mastectomy can improve the postoperative sleep and fatigue of patients,and promote the postoperative recovery.

关 键 词：艾司氯胺酮 乳腺癌根治术 睡眠 疲劳 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]