艾司氯胺酮与术后谵妄的研究进展  

Research progress of esketamine and postoperative delirium

作　　者：高世龙 张培福[1] 王恩强 王启芳 姚泽宇[1] GAO Shilong;ZHANG Peifu;WANG Enqiang;WANG Qifang;YAO Zeyu(Department of Anesthesia,Qinghai Red Cross Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海红十字医院麻醉科,青海西宁810000

出　　处：《中国临床研究》2024年第8期1164-1167,共4页Chinese Journal of Clinical Research

基　　金：青海省科技计划项目(2019-ZJ-7085);青海省卫生健康系统重点课题(2023-wjzdx-86)。

摘　　要：术后谵妄(POD)是老年患者手术后常见的一种并发症,严重影响患者的预后,增加病死率。POD的发病机制目前仍未明确,其危险因素繁杂,预防困难,治疗效果不佳。艾司氯胺酮是一种高亲和性的N-甲基-D-天冬氨酸(NMDA)受体非竞争性抑制药,同时具备麻醉和镇痛作用,除了广泛应用于围术期麻醉诱导与维持、急慢性疼痛的治疗与管理外,艾司氯胺酮在精神疾病和急危重症诊疗等多学科领域同样有较好的临床应用。本文将近年来国内外应用艾司氯胺酮防治POD的作用机制和研究进展进行综述,为临床提供新的思路。Postoperative delirium(POD)is a common complication in elderly patients after surgery,significantly affecting prognosis and increasing mortality rates.The underlying mechanisms of POD remain unclear,with diverse risk factors making prevention difficult and treatment outcomes unsatisfactory.Esketamine is a high-affinity N-methyl-D-aspartate(NMDA)receptor antagonist known for its anesthetic and analgesic properties.Besides its widespread use in perioperative anesthesia and pain management,esketamine has shown promising clinical applications across various disciplines including psychiatry and critical care.This review summarizes recent advances and mechanisms of esketamine in preventing and treating POD,offering new insights for clinical practice.

关 键 词：艾司氯胺酮 术后谵妄 老年患者 精神疾病 麻醉诱导 疼痛治疗 疼痛管理 

分 类 号：R614[医药卫生—麻醉学]