艾司氯胺酮预防性镇痛在脊柱手术中的应用效果  

Application effect of preventive analgesia with esketamine in spinal surgery

作　　者：王雪莹 秦汉[2] 彭晓红[2] WANG Xueying;QIN Han;PENG Xiaohong(School of Medicine,Jianghan University,Wuhan 430056;Anesthesiology Department,Wuhan Fourth Hospital,Wuhan 430030,China)

机构地区：[1]江汉大学医学部,湖北武汉430056 [2]武汉市第四医院麻醉科,湖北武汉430030

出　　处：《临床医学研究与实践》2024年第20期72-75,共4页Clinical Research and Practice

摘　　要：目的探讨艾司氯胺酮预防性镇痛在脊柱手术中的应用效果。方法将接受脊柱手术的60例患者按照随机数字表法分为C组(0.1 mg/kg地佐辛)、S1组(0.25 mg/kg艾司氯胺酮)及S2组(0.5 mg/kg艾司氯胺酮),各20例。比较三组的麻醉效果。结果三组的自主呼吸恢复、苏醒及拔管时间无明显差异(P>0.05);S1组、S2组的躁动评分低于C组(P<0.05)。拔管前30 min至拔管后30 min,三组的收缩压、舒张压、心率无明显差异(P>0.05)。拔管后30 min、2 h、6 h,S1组、S2组的视觉模拟量表(VAS)评分低于C组(P<0.05)。拔管后6 h,S1组、S2组的Bruggrmann舒适度量表(BCS)评分高于C组(P<0.05)。拔管后30 min、2 h、6 h、12 h、24 h,三组的Ramsay评分无明显差异(P>0.05)。结论相比于地佐辛,艾司氯胺酮具有更好的预防性镇痛作用,0.25 mg/kg剂量即可提高镇静镇痛效果,缓解全麻苏醒期躁动。Objective To explore the application effect of preventive analgesia with esketamine in spinal surgery.Methods According to the random number table method,60 patients undergoing spinal surgery were divided into group C(0.1 mg/kg dezocine),group S1(0.25 mg/kg esketamine)and group S2(0.5 mg/kg esketamine),with 20 cases in each group.The anesthetic effects of the three groups were compared.Results There were no significant differences in spontaneous breathing recovery,analepsia and extubation time among the three groups(P>0.05);the agitation score of the group S1 and the group S2 was lower than that of the group C(P<0.05).There were no significant differences in systolic blood pressure,diastolic blood pressure and heart rate between the three groups from 30 min before extubation to 30 min after extubation(P>0.05).At 30 min,2 h and 6 h after extubation,the Visual Analogue Scale(VAS)score of the group S1 and the group S2 was lower than that of the group C(P<0.05).At 6 h after extubation,the Bruggrmann Comfort Scale(BCS)score of the group S1 and the group S2 was higher than that of the group C(P<0.05).There was no significant difference in Ramsay score between the three groups at 30 min,2 h,6 h,12 h and 24 h after extubation(P>0.05).Conclusion Compared with dezocine,esketamine has a better preventive analgesic effect,and the dose of 0.25 mg/kg can improve the sedative and analgesic effect,and relieve agitation during recovery from general anesthesia.

关 键 词：艾司氯胺酮 脊柱手术 预防性镇痛 

分 类 号：R614[医药卫生—麻醉学]