艾司氯胺酮在心血管手术中的应用进展  

Research advances of esketamine in patients undergoing cardiovascular surgery

作　　者：霍泓宇 车璐 吴玉立[2] 翁亦齐[2] 喻文立[2] 许建刚[2] HUO Hongyu;CHE Lu;WU Yuli;WENG Yiqi;YU Wenli;XU Jiangang(The First Central Clinical School,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学第一中心临床学院,300070 [2]天津市第一中心医院麻醉科

出　　处：《临床麻醉学杂志》2024年第7期766-769,共4页Journal of Clinical Anesthesiology

基　　金：天津市科技计划项目多元面上项目(21JCYBJC01190);国家自然科学基金(82072219);天津市医学重点学科(TJYXZDXK-045A)。

摘　　要：艾司氯胺酮是氯胺酮的旋光异构体,兼有镇静、镇痛和遗忘三重作用,在药效和可控性等方面均优于消旋氯胺酮,目前已在欧美等国家广泛应用于麻醉、急救及重症等领域,在国内临床多用于镇静、镇痛、抗抑郁等。艾司氯胺酮在心血管手术中有利于维持稳定的血流动力学、减少炎性因子分泌、缓解术后疼痛。艾司氯胺酮具有拟交感神经作用,可用于血流动力学不稳定及急性心梗患者的麻醉诱导。本文综述了艾司氯胺酮用于心血管手术围术期临床应用价值和局限性,为艾司氯胺酮在心血管手术围术期的应用提供参考。Esketamine is a spin isomer of ketamine,which has the triple effect of sedation,analgesia and amnesia,and is superior to ablative ketamine in terms of efficacy,controllability.It has been widely used in anesthesia,emergency and critical care in Europe and America,and is mostly used for sedation,analgesia and antidepressant in China.Esketamine is used in cardiac surgery to maintain stable hemodynamics,reduce the secretion of inflammatory factors and relieve postoperative pain.Its sympathomimetic effect allows it to be used for the induction of anesthesia in patients with hemodynamic instability and acute heart attack.This paper reviews the recent advance in the clinical value and limitations of esketamine in the perioperative period of cardiovascular surgery and provides a reference for clinicians to use esketamine in the perioperative period of cardiovascular surgery.

关 键 词：艾司氯胺酮 临床麻醉 心血管手术 心肌保护 

分 类 号：R614[医药卫生—麻醉学]