艾司氯胺酮对行ERCP老年患者术后早期认知功能的影响  

Effect of esketamine on early postoperative cognitive function in elderly patients undergoing ERCP

作　　者：陈峰 朱婷婷 徐海 CHEN Feng;ZHU Tingting;XU Hai(Department of Emergency,Second Hospital of Jiaxing Jiaxing 314000,CHINA)

机构地区：[1]嘉兴市第二医院急诊科,浙江314000 [2]嘉兴市第二医院麻醉科,浙江314000

出　　处：《江苏医药》2024年第11期1116-1120,共5页Jiangsu Medical Journal

基　　金：嘉兴市科技计划项目(2022AD30027)。

摘　　要：目的 探讨艾司氯胺酮对行内镜下逆行胰胆管造影术(ERCP)老年患者术后早期认知功能的影响。方法 择期行ERCP老年患者111例随机分为两组。麻醉诱导期,E组57例静脉注射艾司氯胺酮0.2mg/kg, C组54例静脉注射等容量生理盐水。比较两组入手术室(T0)、麻醉诱导完成(T1)、开始内镜检查(T2)、置入十二指肠乳头(T3)和检查结束(T4)时的HR、MAP和SpO_(2),记录两组麻醉诱导时间、手术时间、苏醒时间、离室时间及瑞马唑仑用量。术前24h和术后24、48h时评估蒙特利尔认知评估量表(MoCA)评分。观察围手术期相关不良反应发生情况。结果 与C组比较,E组T1时HR、MAP和SpO_(2)升高,T2时MAP升高,T3时MAP和SpO_(2)升高,苏醒时间缩短,且瑞马唑仑用量减少(P<0.05)。E组术后24、48h时的MoCA评分高于C组(P<0.05)。与C组比较,E组围手术期低血压、心动过缓及低氧血症发生率降低(P<0.05)。结论 艾司氯胺酮能够改善行ERCP老年患者术后早期认知功能,稳定心血管及呼吸系统,减少不良反应的发生。Objective To investigate the effect of esketamine on early postoperative cognitive function in elderly patients undergoing endoscopic retrograde cholangio-pancreatography(ERCP).Methods A total of 1ll elderly patients receiving ERCP were randomly divided into two groups.During anesthesia induction,group E(57 cases)was injected intravenously with esketamine 0.2 mg/kg and group C(54 cases)was injected intravenously with same amount of normal saline.HR,MAP and SpO_(2) at the time points of entering operation room(T0),completion of anesthesia induction(T1),at the beginning of endoscopy(T2),duodenal papilla implantation(T3)and at the end of operation(T4)were compared between the two groups.The induction time,surgery time,recovery time and time of leaving operation room,and consumption of remimazolam were recorded.Montreal cognitive assessment(MoCA)scores were evaluated before operation and at 24 and 48 hours after operation.The relevant adverse reactions in perioperative period were observed.Results Compared to group C,HR,MAP and SpO_(2) were increased at T1,MAP was increased at T2,MAP and SpO_(2) were increased at T3,recovery time was shorter and remimazolam consumption was reduced in group E(P<0.05).MoCA scores were increased at 24 and 48 hours after operation in group E(P<0.05).Compared to group C,the incidences of perioperative hypotension,bradycardia and hypoxemia were decreased in group E(P<0.05).Conclusion In elderly patients undergoing ERCP,esketamine can improve early postoperative cognitive function,stabilize cardiovascular and respiratory function,and reduce the incidence of adverse reactions.

关 键 词：艾司氯胺酮 内镜下逆行胰胆管造影术 认知功能 老年 

分 类 号：R614[医药卫生—麻醉学]