小剂量艾司氯胺酮预先注射减轻小儿丙泊酚中/长链脂肪乳注射痛  

Pretreatment with low-dose esketamine for relieving pain of propofol medium-chain triglyceride/long-chain triglyceride emulsion injection in children

作　　者：姚奕屹 朱义 陈政 杜真 YAO Yiyi;ZHU Yi;CHEN Zheng;DU Zhen(Department of Anesthesiology,The Affiliated Children′s Hospital of Xiangya School of Medicine,Central South University(Hunan Children′s Hospital),Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院)麻醉手术科,长沙410007

出　　处：《中国中西医结合儿科学》2024年第5期440-444,共5页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：湖南省自然科学基金项目(2019JJ50294)。

摘　　要：目的探讨小剂量艾司氯胺酮在减轻小儿丙泊酚中/长链脂肪乳注射痛中的作用。方法选择2023年7~12月湖南省儿童医院收治的行全麻手术患儿165例为研究对象,随机分为3组,对照组、艾司氯胺酮组与利多卡因组各55例。艾司氯胺酮组在注射丙泊酚中/长链脂肪乳前预先静脉注射0.2 mg/kg艾司氯胺酮,利多卡因组预先静脉注射0.5 mg/kg利多卡因,对照组预先静脉注射同体积生理盐水。记录注射痛发生率和疼痛评分,以及不良反应。结果艾司氯胺酮组与利多卡因组注射痛发生率分别为20.0%(11/55)和21.8%(12/55),明显低于对照组45.5%(25/55),差异有统计学意义(P<0.05);艾司氯胺酮组与利多卡因组疼痛评分分别为(0.22±0.46)分、(0.27±0.56)分,明显低于对照组(0.87±1.10)分,差异有统计学意义(P<0.05);艾司氯胺酮组与利多卡因组注射痛发生率和疼痛评分比较差异均无统计学意义(P>0.05)。3组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论小剂量艾司氯胺酮预先处理可降低小儿丙泊酚中/长链脂肪乳注射痛发生率以及疼痛强度,与利多卡因相当,且无严重并发症。Objective To investigate the effect of low-dose esketamine on relieving pain of propofol medium-chain triglyceride/long-chain triglyceride(MCT/LCT)emulsion injection in children.Methods A total of 165 children undergoing general anesthesia treated in Hunan Children′s Hospital from July to December 2023 were selected as the study subjects,and they were randomly divided into 3 groups:control group,esketamine group and lidocaine group,55 cases in each group.The esketamine group was injected with 0.2 mg/kg esketamine before propofol MCT/LCT injection,the lidocaine group was injected with 0.5 mg/kg lidocaine,and the control group was injected with the same volume of normal saline.The incidence of injection pain,pain score and adverse reactions were recorded.Results The incidence of injection pain in esketamine group and lidocaine group was 20.0%(11/55)and 21.8%(12/55),which was significantly lower than that in control group(45.5%,25/55),and the difference was statistically significant(P<0.05).The pain score of esketamine group and lidocaine group was(0.22±0.46)and(0.27±0.56)respectively,which was significantly lower than that of control group(0.87±1.10),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of injection pain or pain score between esketamine group and lidocaine group(P>0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Low-dose esketamine pre-treatment can reduce the incidence and intensity of pain from propofol MCT/LCT injection in children,which is equivalent to lidocaine,and there are no serious complications.

关 键 词：丙泊酚中/长链脂肪乳 注射痛 艾司氯胺酮 利多卡因 儿童 

分 类 号：R971.2[医药卫生—药品]