雾化吸入艾司氯胺酮对甲状腺手术患者术后咽喉部疼痛的影响  

Effect of nebulized inhalation of esketamine on postoperative sore throat in patients undergoing thyroid surgery

作　　者：许克路 沈勤 程玥 Xu Kelu;Shen Qin;Cheng Yue(Department of Anesthesiology,Huainan Xi‐nhua Hospital Affiliated to Anhui University of Science and Technology,Huainan 232052,China)

机构地区：[1]安徽理工大学附属淮南新华医院麻醉科,安徽淮南232052

出　　处：《实用药物与临床》2024年第8期603-607,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探索雾化吸入艾司氯胺酮缓解全身麻醉下甲状腺切除术患者术后咽喉部疼痛(Postoperative sore throat,POST)的有效性与安全性。方法选取2022年3月至2023年8月安徽理工大学附属淮南新华医院择期全身麻醉下行甲状腺切除术的患者75例,年龄21~71岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级,手术时间1~3 h,采用随机数字表法分为对照组(雾化液:生理盐水5 ml)25例,试验组S组(雾化液:艾司氯胺酮50 mg+生理盐水5 ml)25例,试验组ES组(雾化液:艾司氯胺酮100 mg+生理盐水5 ml)25例。三组患者全身麻醉前30 min接受统一的雾化装置进行雾化吸入。雾化完成后,接受同质化的麻醉方案及管理。记录三组患者拔管后即刻(T_(0))、2 h(T_(1))、4 h(T_(2))、6 h(T_(3))、12 h(T_(4))、24 h(T5)POST发生例数、程度;在雾化前、诱导前记录心率(HR)、收缩压(SBP)、舒张压(DBP)和平均动脉压(MAP)等血流动力学变量;记录三组患者术后恶心、呕吐、口干、幻视、呼吸抑制等各种并发症的情况。结果在T_(0)、T_(4)、T_(5)时,三组患者POST发生例数及严重程度差异无统计学意义(P>0.05)。与对照组比较,S组和ES组T_(1)、T_(2)、T_(3)时患者POST发生例数减少,严重程度减轻,差异具有统计学意义(P<0.05)。对照组雾化前与诱导前血流动力学参数差异无统计学意义(P>0.05)。S组与ES组诱导前血流动力学各项参数均高于雾化前,差异有统计学意义(P<0.05)。三组患者术后恶心、呕吐、口干等不良反应的发生情况差异无统计学意义(P>0.05)。三组患者均未出现幻视及呼吸抑制不良反应。结论雾化吸入艾司氯胺酮能够缓解全身麻醉下甲状腺切除术患者POST,而增加雾化吸入艾司氯胺酮的浓度,并不能进一步降低POST的发生率及严重程度。Objective To explore the effectiveness and safety of nebulized inhalation of esketamine to alleviate postoperative sore throat(POST)in patients undergoing thyroidectomy under general anesthesia.Methods Totally 75 patients undergoing thyroid surgery under elective general anesthesia in Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology from March 2022 to August 2023,aged 21~71 years old,with American Society of Anesthesiologists(ASA)grades I~III and surgery time ranging from 1 to 3 hours were selected.They were randomly divided into control group(nebulized solution:5 ml of normal saline,n=25),experimental group S(nebulized solution:50 mg of esketamine+5 ml of normal saline,n=25)and experimental group ES(nebulized solution:100 mg of esketamine and 5 ml of normal saline,n=25)by random number table method.Three groups of patients received a unified nebulization device for nebulized inhalation 30 minutes before general anesthesia.After nebulization,they received a homogenized anesthesia plan and management.The number and severity of POST events immediately(T_(0)),2 h(T_(1)),4 h(T_(2)),6 h(T_(3)),12 h(T_(4)),and 24 h(T_(5))after extubation in three groups of patients was recorded.Before nebulization and induction,hemodynamic variables such as heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)were recorded.The incidence of various complications such as nausea,vomiting,dry mouth,hallucinations,and respiratory depression in three groups of patients was recorded.Results There was no statistically significant difference in the number and severity of POST among the three groups at T0,T4,or T5(P>0.05).Compared with control group,the incidence of POST in group S and group ES decreased at T_(1),T_(2) and T_(3),and the severity decreased(P<0.05).There was no statistically significant difference in hemodynamic parameters in control group between before nebulization and before induction(P>0.05).The hemodynamic parameters of group S and group ES be

关 键 词：艾司氯胺酮 雾化吸入 甲状腺手术 术后咽喉部疼痛 

分 类 号：R614[医药卫生—麻醉学]