术中输注小剂量艾司氯胺酮对甲状腺手术病人术后疲劳综合征的影响  

Effect of the intraoperative infusion of low-dose esketamine on postoperative fatigue syndrome of patients treated with thyroidectomy

作　　者：王义凯 闫声明 李晓红 李强 刘伟[1] WANG Yikai;YAN Shengming;LI Xiaohong;LI Qiang;LIU Wei(Department of Anesthesia,Bozhou People′s Hospital,Bozhou Anhui 236800;Department of Anesthesiology,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004;Department of Cell Biology,College of Life Science and Technology,Bengbu Medical University,Bengbu Anhui 233030,China)

机构地区：[1]安徽省亳州市人民医院麻醉科,236800 [2]蚌埠医科大学第一附属医院麻醉科,安徽蚌埠233004 [3]蚌埠医科大学生命科学学院细胞生物学系,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2024年第7期874-878,共5页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(KJ020A0580)。

摘　　要：目的:探讨术中输注小剂量艾司氯胺酮对甲状腺手术病人术后疲劳综合征(POFS)的影响。方法:选取在全麻下行甲状腺手术病人100例,随机分成艾司氯胺酮组(LKET组)和0.9%氯化钠注射液对照组(对照组),各50例。LKET组麻醉诱导后静脉给予艾司氯胺酮0.5 mg/kg,继之以4μg·kg^(-1)·min-1持续泵注;对照组给予等体积0.9%氯化钠注射液。记录病人术中舒芬太尼用量、平均动脉压、术后拔管时间和苏醒时间、出手术室时Ramsay评分及术后不良反应。并于术后1、3、7 d进行Chalder疲劳量表(FS-14)、匹兹堡睡眠质量指数(PSQI)和视觉模拟评分法(VAS)的评分,统计POFS发生率。结果:与对照组比较,LKET组术中舒芬太尼用量更少(P<0.01),出手术室时Ramsay评分更高(P<0.01),且术后不良反应发生率组间差异无统计学意义(P>0.05)。LKET组术后1、3、7 d的FS-14评分、VAS评分、PSQI评分较对照组明显降低(P<0.01),术后1、3 d POFS发生率降低(P<0.05和P<0.01)。结论:全麻术中输注小剂量艾司氯胺酮可改善甲状腺手术病人术后疲劳,降低术后POFS发生率,改善病人睡眠质量。Objective:To investigate the effects of the intraoperative infusion of low-dose esketamine on postoperative fatigue syndrome(POFS)in patients treated with thyroidectomy.Methods:A total of 100 patients treated with thyroidectomy under general anesthesia were randomly divided into the esketamine group(LKET group)and 0.9%sodium chloride injection control group(control group)(50 cases in each group).After anesthesia induction,the 0.5 mg/kg esketamine was administered intravenously,followed by 4μg·kg^(-1)·min-1 continuous pumping in the LKET group.The control group was given equal volume 0.9%sodium chloride injection.The intraoperative sufentanil dosage,mean arterial pressure,postoperative extubation time and recovery time,Ramsay score and postoperative adverse reactions in two groups were recorded.The fatigue scale(FS-14),Pittsburgh sleep quality index(PSQI)and VAS scores in two groups were recorded after 1,3 and 5 days of operation,and the incidence rate of POFS was calculated.Results:Compared with the control group,the intraoperative sufentanil dosage in the LKET group was less(P<0.01),the Ramsay score was higher(P<0.01),and there was no statistical significance in the incidence rate of postoperative adverse reactions between two groups(P>0.05).The scores of FS-14,VAS and PSQI in the LKET group at 1,3 and 7 days after surgery were significantly lower than those in control group(P<0.01),and the incidence of POFS at 1 and 3 days after surgery was significantly lower(P<0.05 and P<0.01).Conclusions:The low-dose esketamine under general anesthesia can improve the postoperative fatigue and sleep quality,and reduce the incidence of POFS after thyroidectomy.

关 键 词：甲状腺切除术 术后疲劳综合征 艾司氯胺酮 

分 类 号：R653[医药卫生—外科学]