氯胺酮及其右旋异构体改善围术期睡眠障碍的研究进展  

Research progress on ketamine and its dextroisomer in improving perioperative sleep disorders

作　　者：马育蕾 范美含 任奥林 王敏[1] 朱敏敏[1] MA Yulei;FAN Meihan;REN Aolin;WANG Min;ZHU Minmin(Wuxi Second People′s Hospital Affiliated to Nanjing Medical University,Wuxi,Jiangsu 214400,China)

机构地区：[1]南京医科大学附属无锡市第二人民医院,江苏无锡214400

出　　处：《徐州医科大学学报》2024年第11期791-795,共5页Journal of Xuzhou Medical University

基　　金：江苏省医院协会项目(JSYGY-3-2024-123)。

摘　　要：围术期睡眠障碍可表现为阻塞性睡眠呼吸暂停、睡眠总时间不足、夜间觉醒增加、昼夜节律紊乱等,对疾病的预后产生极大的负面影响,亟需寻找更优化的预防及治疗措施。氯胺酮及其右旋异构体(艾司氯胺酮)作为N-甲基-D-天冬氨酸(NMDA)受体拮抗剂,在抗抑郁、镇静、镇痛方面的作用已被广泛熟知。近年来,其对睡眠周期及昼夜节律的调节作用也被证实,氯胺酮显著改善睡眠质量可能与抗抑郁、抗炎镇痛及对生物钟基因的调控等作用相关。Perioperative sleep disorders can present as obstructive sleep apnea,insufficient total sleep time,increased nighttime awakenings,and circadian rhythm disturbances,which have profoundly negative effects on disease prognosis.There is an urgent need for more effective preventive and therapeutic strategies.As an N-methyl-D-aspartate(NMDA)receptor antagonist,ketamine and its dextroisomer(esketamine)are widely recognized for their antidepressant,sedative,and analgesic effects.Recent studies have confirmed their regulatory effects on sleep cycles and circadian rhythms,significantly improving sleep quality.These effects may be related to their antidepressant,anti-inflammatory,analgesic properties,and regulation of circadian clock genes.

关 键 词：氯胺酮 艾司氯胺酮 围术期 睡眠障碍 慢波睡眠 昼夜节律 

分 类 号：R614.2[医药卫生—麻醉学]