艾司氯胺酮多模式镇痛对ICU机械通气非手术患者阿片类药物用量和胃运动功能的影响  

Effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical ICU patients

作　　者：隆毅 刘倩 李蕊 吴桂新 何蔼婷 蒋正英 LONG Yi;LIU Qian;LI Rui;WU Guixin;HE Aiting;JIANG Zhengying(Dept.of Critical Care Medicine,Chongqing University Cancer Hospital,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院重症医学科,重庆400030

出　　处：《中国药房》2024年第4期468-471,共4页China Pharmacy

基　　金：重庆市科卫联合医学科研项目(No.2020FYYX091);重庆市沙坪坝区决策咨询与管理创新项目指导性计划项目(No.Jcd2022+100)。

摘　　要：目的探讨艾司氯胺酮多模式镇痛对重症监护病房(ICU)机械通气非手术患者阿片类药物用量和胃运动功能的影响。方法选择我院2023年2月1日至7月31日ICU机械通气非手术患者40例,使用信封法随机分为对照组和艾司氯胺酮(S-K)组,每组20例患者。对照组患者给予舒芬太尼,S-K组患者恒速输注盐酸艾司氯胺酮注射液0.2 mg/(kg·h)+舒芬太尼。比较两组患者的治疗期长度、镇痛达标率、镇静水平、镇痛镇静药物使用量及胃运动功能指标。结果两组患者的治疗期长度、镇痛达标率、镇静水平、丙泊酚和咪达唑仑使用量比较,差异均无统计学意义(P>0.05)。S-K组患者舒芬太尼使用量显著小于对照组(P<0.05)。与随机分组后1 h比较,S-K组患者随机分组后72 h的胃窦收缩频率、胃窦收缩幅度、胃窦运动指数均显著提高,且显著高于对照组(P<0.05)。结论艾司氯胺酮可在保证镇痛、镇静水平的同时,降低ICU机械通气非手术患者的阿片类药物使用量,改善胃运动功能。OBJECTIVE To investigate the effects of esketamine for multimodal analgesia on opioid consumption and gastric motility in mechanically ventilated non-surgical intensive care unit(ICU)patients.METHODS Forty cases of mechanically ventilated non-surgical patients in the ICU of our hospital from February 1st,2023 to July 31st,2023 were selected and randomly divided into control group and esketamine(S-K)group using grouping method with opaque envelopes,with 20 cases in each group.Control group was given sufentanil,and S-K group was infused with Esketamine hydrochloride injection at a constant rate of 0.2 mg/(kg·h)+sufentanil.The treatment period length,analgesic compliance rate,sedation level,analgesic and sedative consumption,and gastric motility indexes were compared between the two groups.RESULTS There was no statistically significant difference in the treatment period length,analgesic compliance rate,sedation level,or the consumption of propofol and midazolam between the two groups(P>0.05).The consumption of sufentanil in the S-K group was significantly less than control group(P<0.05).Compared with 1 h after randomization,the antral contraction frequency,antral contraction amplitude and antral motility index of patients in the S-K group were significantly higher at 72 h after randomization and were significantly higher than control group(P<0.05).CONCLUSIONS Esketamine may reduce opioid consumption and improve gastric motility in mechanically ventilated non-surgical ICU patients while ensuring a level of analgesic sedation.

关 键 词：艾司氯胺酮 多模式镇痛 机械通气 重症监护病房 胃运动功能 

分 类 号：R971.3[医药卫生—药品] R614.2[医药卫生—药学]