单次注射亚麻醉剂量氯胺酮对腹腔镜结直肠癌根治术患者术后疲劳综合征的影响  

Effect of single injection of a sub-anesthetic dose of ketamine on postoperative fatigue syndrome in patients undergoing laparoscopic radical resection of colorectal cancer

作　　者：郭文静 孙韧[1] GUO Wenjing;SUN Ren(Department of Anesthesiology,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang,Jiangsu 215600,China)

机构地区：[1]苏州大学附属张家港医院麻醉科,江苏张家港215600

出　　处：《徐州医科大学学报》2024年第4期291-295,共5页Journal of Xuzhou Medical University

基　　金：苏州市科技计划项目(SKYDS2023051)。

摘　　要：目的探讨单次注射亚麻醉剂量氯胺酮对腹腔镜结直肠癌根治术患者术后疲劳综合征的影响。方法选取2020年1月—2022年9月就诊于苏州大学附属张家港医院行腹腔镜结直肠癌根治术的老年患者共计90例。纳入标准:年龄60~75岁,ASAⅡ—Ⅲ级,体重指数(BMI)18.5~27.9 kg/m^(2),术前1dChristensen疲劳评分≤4分,预期手术时间小于6 h,预期失血量低于800 mL。患者随机纳入氯胺酮组(K组)或安慰剂组(P组),每组各纳入45例患者。于术前1 d、术后3 d、术后5 d、术后7 d评估患者Christensen疲劳评分和简明围术期疲劳检测量表(ICFS-10)评分。于麻醉诱导前10 min(T0)、手术结束即刻(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)抽取外周静脉血,检测白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。记录拔管时间、PACU停留时间以及苏醒延迟、躁动、恶心呕吐、复视发生情况。结果2组患者拔管时间、麻醉后监测治疗室(PACU)停留时间的比较差异无统计学意义(P>0.05)。2组患者苏醒延迟、躁动、恶心呕吐、复视发生率的比较差异无统计学意义(P>0.05)。K组患者术后3 d、术后5 d、术后7 d的Christensen疲劳评分和ICFS-10评分明显低于P组患者,差异有统计学意义(P<0.05)。2组患者术后3 d Christensen疲劳评分和ICFS-10评分明显高于同组其他时点,差异有统计学意义(P<0.05)。K组患者术后T1至T4时点的IL-6和TNF-α水平明显低于P组患者,差异有统计学意义(P<0.05)。2组患者T1时点IL-6和TNF-α水平明显高于同组其他时点,差异有统计学意义(P<0.05)。结论单次注射亚麻醉剂量氯胺酮能够改善腹腔镜结直肠癌根治术患者术后疲劳综合征,且对苏醒质量无明显不良影响。Objective To investigate the effect of single injection of a sub-anesthetic dose of ketamine on postoperative fatigue syndrome in patients undergoing laparoscopic radical resection of colorectal cancer.Methods A total of 90 elderly patients who underwent laparoscopic radical resection of colorectal cancer in Zhangjiagang Hospital Affiliated to Soochow University from January 2020 to September 2022 were selected.Inclusion criteria:aging 60-75 years old,ASAⅡ—Ⅲ,body mass index(BMI)18.5-27.9 kg/m^(2),Christensen fatigue score≤4 points 1 day before surgery,expected operation time less than 6 h,and expected blood loss less than 800 mL.The patients were randomly divided into two groups(n=45):a ketamine group(group K)and a placebo group(group P).Their Christensen fatigue score and ICFS-10 were assessed 1 day before surgery,3 days after surgery,5 days after surgery,and 7 days after surgery.Peripheral venous blood samples were collected 10 min before anesthesia induction(T0),immediately after surgery(T1),6 h after surgery(T2),12 h after surgery(T3),and 24 h after surgery(T4).The levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured.The extubation time,the length of PACU stay,and the incidences of delayed recovery,agitation,nausea and vomiting,and diplopia were recorded.Results There was no statistical difference in the extubation time and the length of PACU stay between the two groups(P>0.05).There was no statistical difference in the incidences of delayed recovery, agitation, nausea and vomiting and diplopiabetween the two groups (P>0. 05). Group K showed remarkable decreases in Christensen fatigue score and ICFS-10 on3, 5 and 7 days after surgery, compared with group P (P<0. 05). Christensen fatigue score and ICFS-10 in both groups3 days after surgery were significantly higher than those at other time points (P<0. 05). The levels of IL-6 and TNF-αin group K were significantly lower than those in group P at T1 to T4 (P<0. 05). The levels of IL-6 and TNF-α in bothgroups at T1 were signifi

关 键 词：氯胺酮 术后疲劳综合征 腹腔镜结直肠癌根治术 老年 

分 类 号：R614[医药卫生—麻醉学]