氯胺酮作为麻醉佐剂在微创根治性前列腺切除术中对患者免疫功能的影响  

Effect of ketamine as local anesthetic adjuvant on Immune function in patients undergoing laparoscopic radical prostatectomy

作　　者：罗锋[1] 吴燕荣 李建军[1] 吴照飞 陈英 Luo Feng;Wu Yanrong;Li Jianjun;Wu Zhaofei;Chen Ying(Hankou Hospital in Wuhan,Wuhan,Hubei 430000,China)

机构地区：[1]武汉市汉口医院,湖北武汉430000

出　　处：《首都食品与医药》2024年第23期62-65,共4页Capital Food Medicine

摘　　要：目的 探讨氯胺酮作为麻醉佐剂在微创根治性前列腺切除术中对患者免疫功能的影响.方法 选取我院2023年1月-2023年12月收治的前列腺癌须行经腹腔镜前列腺癌根治术治疗患者104例,均分为对照组、观察组各52例,对照组患者采用全身麻醉,观察组患者在对照组基础上采用氯胺酮佐助全身麻醉.比较两组患者血流动力学指标、视觉模拟评分(Visual Analogue Scale,VAS)结果、膀胱痉挛情况、免疫功能、认知功能、不良反应.结果 两组患者T0、T1、T2、T3时刻HR、MAP无明显差异(P>0.05);观察组患者术后4h、8h、12h VAS得分均低于对照组(P<0.05);观察组膀胱痉挛次数、膀胱痉挛持续时间均明显低于对照组(P<0.05);术后24h,观察组CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组(P<0.05);两组患者术前、术后24h MoCA认知功能评分比较,均无明显差异(P>0.05);两组不良反应发生率(11.54%vs 9.62%)无明显差异(P>0.05).结论 微创根治性前列腺切除术中采用氯胺酮作为麻醉佐剂可有效提高镇痛效果,改善术后免疫功能,减轻膀胱痉挛.Objective To investigate the effect of ketamine as local anesthetic adjuvant on immune function in patients undergoing laparoscopic radical prostatectomy.Methods A total of 104 patients with prostate cancer undergoing laparoscopic radical prostatectomy in our hospital from January 2023 to December 2023 were enrolled,patients were divided evenly into control group(received general anesthesia,52 cases)and observation group(received ketamine assisted general anesthesia,52 cases).Then hemodynamic indexes,postoperative Visual Analogue Scale(VAS),bladder spasm,immune function,cognitive function and adverse reactions were compared.Results HR and MAP at T0,T1,T2,and T3 showed no significant difference between groups(P>0.05).VAS scores of observation group at postoperative 4h,8h and 12h were all lower than those of control group(all P<0.05).The frequency and duration of bladder spasm in patients of observation group were better than the two indicators of control group(P<0.05).CD4^(+)and CD4^(+)/CD8^(+)levels at postoperative 24h were significantly higher in observation group than in control group(P<0.05).The preoperative and postoperative 24h MoCA score had no significant difference(P>0.05).The anesthesia related adverse reaction rate(11.54%vs 9.62%)showed no statistic difference between two groups(P>0.05).Conclusion Application of ketamine as local anesthetic adjuvant on immune function in patients undergoing laparoscopic radical prostatectomy can effectively improve analgesia effect,improve the immune function,and alleviate the bladder spasm.

关 键 词：氯胺酮 经腹腔镜前列腺切除术 镇痛 免疫功能 

分 类 号：R697.3[医药卫生—泌尿科学]