艾司氯胺酮的药理学特性及其在小儿麻醉中的应用进展  

Pharmacological characteristics of esketamine and its application progress in pediatric anesthesia

作　　者：金宝伟[1] 郭建荣 JIN Baowei;GUO Jianrong(Department of Anesthesiology,Shaoxing People's Hospital,Shaoxing 312000,Zhejiang,China;Department of Anesthesiology,Shanghai Gongli Hospital,Naval Military Medical University,Shanghai 200135,China)

机构地区：[1]绍兴市人民医院麻醉科,浙江绍兴312000 [2]海军军医大学附属公利医院麻醉科,上海200135

出　　处：《中国临床药理学与治疗学》2024年第3期328-333,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：浙江省公益技术应用研究资助项目(LGD22H160011)。

摘　　要：艾司氯胺酮是N-甲基-D-天冬氨酸(NMDA)受体的拮抗剂,通过与NMDA受体、阿片受体、M胆碱受体、单胺受体、腺苷受体和其他嘌呤受体相互作用发挥抗焦虑、催眠、镇静和镇痛作用。作为氯胺酮更强效的S型异构体,效力大约是氯胺酮的2倍。与氯胺酮相比,艾司氯胺酮具有起效和代谢快、强镇痛、呼吸抑制轻微、认知功能恢复快、精神副反应发生率低等特点,成为小儿临床麻醉药物的新选择。本文就艾司氯胺酮的药理学特性和近年在小儿麻醉中的应用研究进展作一综述,为小儿围手术期安全用药提供参考。Esketamine is an antagonist of the Nmethyl-D-aspartate(NMDA)receptor and exerts antianxiety,hypnotic,sedative,and analgesic effects by interacting with NMDA receptors,opioid receptors,M-choline receptors,monoamine receptors,adenosine receptors,and other purine receptors.As the more potents isomer of ketamine,it is about twice as potent as ketamine.Compared with ketamine,esketamine has the characteristics of rapid onset and metabolism,strong analgesia,slight respiratory depression,rapid recovery of cognitive function,and low incidence of psychiatric side effects.It has become a new choice of pediatric anesthesia drugs.This article reviews the pharmacological properties of esketamine and its recent application in pediatric anesthesia,and provides reference for the safe use of esketamine in pediatric perioperative period.

关 键 词：艾司氯胺酮 镇静 镇痛 小儿 

分 类 号：R614[医药卫生—麻醉学]