小剂量艾司氯胺酮对垂体瘤患者经鼻蝶入路垂体瘤切除术后早期情绪反应的影响  

Effect of low dose esketamine on early postoperative emotional response of the patients with pituitary tumor after transnasal transsphenoidal pituitary tumor resection

作　　者：童恒 沈璐艳 TONG Heng;SHEN Luyan(Department of Anesthesiology,Affiliated Li Huili Hospital,Ningbo University,Ningbo 315000,CHINA)

机构地区：[1]宁波大学附属李惠利医院麻醉科,浙江315000

出　　处：《江苏医药》2024年第10期1044-1047,共4页Jiangsu Medical Journal

摘　　要：目的观察小剂量艾司氯胺酮对垂体瘤患者经鼻蝶入路垂体瘤切除术后早期情绪反应的影响。方法择期行经鼻蝶入路垂体瘤切除术的50例垂体瘤患者随机均分为两组。全身麻醉诱导后,A组和B组分别静脉泵注艾司氯胺酮0.25mg·kg^(-1)·h^(-1)和等体积生理盐水。评估两组术前1d和术后48h的医院焦虑抑郁量表(HAD)和40项恢复质量评分量表(QoR-40)评分,比较两组围手术期和麻醉恢复室观察期相关指标。结果与术前比较,A组术后HAD抑郁分量表评分升高,而QoR-40的行为独立评分和总分下降(P<0.05),B组术后HAD焦虑分量表和抑郁分量表评分均升高,而QoR-40的情绪、行为独立评分和总分下降(P<0.05);与B组比较,A组术后HAD焦虑分量表和抑郁分量表评分均降低,而QoR-40的情绪评分升高(P<0.05)。与B组比较,A组术中丙泊酚和雷米芬太尼用量、拔管后VAS疼痛评分、Ricker镇静-躁动评分、苏醒期呛咳发生率以及补救镇痛率均降低(P<0.05)。两组患者均未出现不良反应。结论小剂量艾司氯胺酮可以改善经鼻蝶入路垂体瘤切除术患者术后焦虑、抑郁情绪,不增加术后不良反应。Objective To observe the effect of low dose esketamine on early postoperative emotional response of the patients with pituitary tumor underwent transnasal transsphenoidal pituitary tumor resection.Methods Fifty patients with pituitary tumors underwent transnasal transsphenoidal pituitary tumor resection were randomly divided into two groups with 25 cases each.After anesthesia induction,group A was pumped esketamine 0.25 mg·kg^(-1)·h^(-1),and group B was infused equal volume of normal saline as the control.The scores of hospital anxiety and depression scale(HAD)and 40-item quality of recovery scale(QoR-40)were evaluated one day before and 48 hours after surgery.The relevant indicators in operation and PACU stay were compared between the two groups.Results Compared to before,the depression subscale score of HAD was increased,while behavioral independent score and total score of QoR-40 were decreased after surgery in group A(P<0.05).Compared to before,the subscale scores of anxiety and depression of HAD were increased,while emotional and behavioral independent scores and total score of QoR-40 were decreased after surgery in group B(P<0.05).Compared with group B,the subscale scores of anxiety and depression of HAD were decreased,while emotional score of QoR-40 was increased in group A after surgery(P<0.05).Compared with group B,the dosage of propofol and remifentanil,VAS pain score and Ricker sedation-agitation score after extubation,incidence of choking during recovery,and the rate of remedial analgesia were all decreased in group A(P<0.05).No adverse reactions occurred in the two groups.Conclusion Low dose esketamine can improve the postoperative anxiety and depression without increase of adverse reactions in the patients after transnasal transsphenoidal pituitary tumor resection.

关 键 词：艾司氯胺酮 垂体瘤 焦虑 抑郁 

分 类 号：R614[医药卫生—麻醉学]