小剂量艾司氯胺酮在腹腔镜肝癌切除手术患者围手术期麻醉中的应用  

The Application of Low-Dose Esketamine in Perioperative Anesthesia for Patients Undergoing Laparoscopic Liver Cancer Resection

作　　者：代成勇 曾健豪 汪飞[2] DAI Chengyong;ZENG Jianhao;WANG Fei(Department of Medical College,Shantou University,Shantou,Guangdong 515041,China;Department of Anesthesiology,The First People’s Hospital of Huizhou,Huizhou,Guangdong 516000,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]惠州市第一人民医院麻醉科,广东惠州516000

出　　处：《中国医药指南》2025年第2期46-48,共3页Guide of China Medicine

摘　　要：目的探究小剂量艾司氯胺酮在腹腔镜肝癌切除手术患者围手术期麻醉中的应用。方法选取2023年12月至2024年5月惠州市第一人民医院收治的70例行腹腔镜肝癌切除术患者,按照随机数字表法设置对照组(0.9%氯化钠溶液)和观察组(小剂量艾司氯胺酮),各35例。对比两组手术情况(手术时间、苏醒时间、拔管时间、补救使用舒芬太尼用量情况)、不良反应发生情况、平均动脉压(MAP)和SaO2。结果观察组患者的手术时间、苏醒时间、拔管时间、补救使用舒芬太尼用量均低于对照组(P<0.05)观察组术后不良反应总发生率为8.57%,低于对照组的28.60%(P<0.05)。观察组T3、T4、T5时刻的MAP水平均低于对照组(P<0.05)。术后24 h、72 h、7 d,观察组SaO2水平均高于对照组(P<0.05)。结论对行腹腔镜肝癌切除手术患者采取小剂量艾司氯胺酮治疗,可辅助术后镇痛效果,无明显延长患者苏醒时间,降低术后不良反应发生率,有利于患者手术安全性。Objective To explore the application of low-dose esketamine in perioperative anesthesia for patients undergoing laparoscopic liver cancer resection.Methods A total of Seventy patients who underwent laparoscopic liver cancer resection at The First People’s Hospital of Huizhou from December 2023 to May 2024 were selected and randomly assigned to a control group(0.9%sodium chloride solution)and an observation group(low-dose esketamine),with 35 cases in each group.The surgical outcomes(operation time,awakening time,extubation time,and the amount of rescue sufentanil used),adverse reaction occurrence,mean arterial pressure(MAP),and SaO2 were compared between the two groups.Results The operation time,awakening time,extubation time,and the amount of rescue sufentanil used in the observation group were all lower than those in the control group(P<0.05).The overall incidence of postoperative adverse reactions in the observation group was 8.57%,which was lower than the control group’s 28.60%(P<0.05).The MAP levels at T3,T4,and T5 times in the observation group were all lower than those in the control group(P<0.05).The SaO2 levels in the observation group at 24 hours,72 hours,and 7 days postoperatively were all higher than those in the control group(P<0.05).Conclusions Low-dose ketamine can be used as an adjunct to postoperative analgesia in patients undergoing laparoscopic hepatectomy for liver cancer,and it can not significantly prolong the recovery time of patients and reduce the incidence of postoperative adverse reactions.

关 键 词：肝癌 艾司氯胺酮 腹腔镜 麻醉 围手术期 

分 类 号：R735.7[医药卫生—肿瘤]