艾司氯胺酮对三叉神经痛行经皮三叉神经半月节球囊压迫术患者三叉心反射的影响  

Effect of esmketamine on trigeminal cardiac reflex in patients with trigeminal neuralgia undergoing percutaneous balloon compression

作　　者：张焕焕 何金华 张梦 杨歌 张彧 李建立[1] Zhang Huanhuan;He Jinhua;Zhang Meng;Yang Ge;Zhang Yu;Li Jianli(Department of Anesthesiology,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院麻醉科,石家庄050051

出　　处：《中国医药》2024年第7期1015-1018,共4页China Medicine

基　　金：河北省医学科学研究课题计划(20240115)。

摘　　要：目的探讨艾司氯胺酮对三叉神经痛行经皮三叉神经半月节球囊压迫术(PBC)患者三叉心反射(TCR)的影响。方法选择2023年1—8月于河北省人民医院就诊的80例因三叉神经痛行PBC的患者,按照随机数字表法分为艾司氯胺酮组和对照组,各40例。对照组麻醉诱导采用咪达唑仑+舒芬太尼+苯磺顺阿曲库铵+丙泊酚;艾司氯胺酮组麻醉诱导采用咪达唑仑+舒芬太尼+苯磺顺阿曲库铵+丙泊酚+艾司氯胺酮。比较2组麻醉诱导前(T_(0))、手术开始前(T_(1))和穿刺卵圆孔时(T_(2))患者的心率和平均动脉压(MAP),穿刺卵圆孔时TCR发生率及围手术期不良反应总发生率。结果2组患者T_(1)、T_(2)时点的心率、MAP均显著低于T_(0)时点,艾司氯胺酮组T_(1)、T_(2)时点的心率、MAP均显著高于对照组,差异均有统计学意义(均P<0.05)。艾司氯胺酮组患者TCR发生率显著低于对照组[15.0%(6/40)比45.0%(18/40)],差异有统计学意义(P<0.05)。艾司氯胺酮组和对照组不良反应总发生率差异无统计学意义[22.5%(9/40)比12.5%(5/40)](P>0.05)。结论艾司氯胺酮可降低三叉神经痛行PBC患者TCR的发生率,提高患者围手术期安全性。Objective To investigate the effect of esketamine on trigeminal cardiac reflex(TCR)in patients with trigeminal neuralgia undergoing percutaneous balloon compression(PBC).Methods A total of 80 patients with trigeminal neuralgia who underwent PBC in Hebei General Hospital from January to August 2023 were selected,and they were divided into esketamine group and control group according to the random number table method,with 40 cases in each group.The control group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,and propofol.The esketamine group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,propofol,and esketamine.The heart rate and mean arterial pressure(MAP)before induction of anesthesia(T_(0)),before the start of surgery(T_(1))and at the time of foramen ovale puncture(T_(2)),the incidence of TCR at the time of foramen ovale puncture,and the incidence of perioperative adverse reactions were compared between the two groups.Results The heart rate and MAP of patients in the two groups at time points T_(1) and T_(2) were significantly lower than those at time point T_(0),and the heart rate and MAP of the esketamine group at time points T_(1) and T_(2) were significantly higher than those of the control group(all P<0.05).The incidence of TCR was significantly lower in the esmketamine group than that in the control group[15.0%(6/40)vs 45.0%(18/40)](P<0.05).There was no significant difference in the total incidence of adverse reactions between the esmketamine group and the control group[22.5%(9/40)vs 12.5%(5/40)](P>0.05).Conclusion Esketamine can reduce the incidence of TRC in patients with trigeminal neuralgia undergoing PBC,and improve the perioperative safety of patients.

关 键 词：三叉神经痛 艾司氯胺酮 三叉心反射 经皮三叉神经半月节球囊压迫术 

分 类 号：R745.1[医药卫生—神经病学与精神病学]