低剂量艾司氯胺联合右美托咪定对腹腔镜全子宫切除术后患者疼痛及睡眠的影响  

Effects of low-dose esketamine combined with dexmedetomidine for anesthesia to patients with total laparoscopic hysterectomy on their postoperative pain,depression,anxiety and sleep quality

作　　者：张常乐 徐帅 ZHANG Changle;XU Shuai(Xian Daring Hospital,Xian,Shanzi Province,710003)

机构地区：[1]陕西省西安大兴医院,710003

出　　处：《中国计划生育学杂志》2025年第1期66-71,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨低剂量艾司氯胺(ESK)联合右美托咪定(DEX)对腹腔镜全子宫切除术(TLH)患者术后疼痛及睡眠的影响。方法:选取2022年2月-2023年2月本院择期行TLH的子宫肌瘤患者98例,随机数表法分为联合组和对照组各49例,分别接受低剂量ESK联合DEX麻醉和常规麻醉。比较两组疼痛程度、疼痛应激指标、抑郁、焦虑情绪及睡眠质量。结果:术后24h,两组视觉模拟评分、疼痛等级指数和当前疼痛强度评分均降低,且联合组(3.28±0.97分、4.42±1.46分、2.26±0.54分)低于对照组(4.67±1.26分、6.40±1.33分、3.11±0.60分),两组血清皮质醇、醛固酮、去甲肾上腺素水平均升高但联合组低于对照组,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)得分均降低且联合组(37.58±7.25分、40.25±7.71分)低于对照组(43.83±6.48分、46.47±8.33分);两组睡眠效率指数以及快动眼睡眠时间值均降低但联合组(61.37±7.71、14.52%±3.57%)高于对照组(54.37±7.68、12.71%±3.88%),两组觉醒指数均升高但联合组(7.63±1.40)低于对照组(9.14±2.66)(P<0.05)。结论:ESK联合DEX不仅能有效减轻TLH术患者术后疼痛、抑郁焦虑情绪,同时对改善睡眠有着积极效果。Objective:To investigate the effects of low-dose esketamine(ESK)combined with dexmedetomidine(DEX)for anesthesia to patients with total laparoscopic hysterectomy(TLH)on their postoperative pain,depression and anxiety and sleep quality.Methods:A total of 98 patients with uterine fibroids who wanted the elective TLH in the hospital were selected and were divided into the study group(49 cases with low-dose ESK mixed with DEX for anesthesia)and the control group(49 cases with conventional anesthesia)by random number table method from February 2022 to February 2023.The pain degree,the pain stress indexes values,the depression,the anxiety and the sleep quality of the patients were compared between the two groups.Results:At 24 hours after operation,the scores of the visual analogue scale,pain rating index and current pain intensity of the patients in the two groups had decreased significantly,and the which(3.28±0.97 points,4.42±1.46 points and 2.26±0.54 points)of the patients in the study group were significantly lower than those(4.67±1.26 points,6.40±1.33 and 3.11±0.60 points)of the patients in the control group.The levels of the serum cortisol,aldosterone and norepinephrine of the patients in the two groups had increased significantly,but which of the patients in the study group were significantly lower than those of the patients in the control group.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores of the patients in the two groups had decreased significantly,and which(37.58±7.25 points and 40.25±7.71 points)of the patients in the study group were significantly lower than those(43.83±6.48 points and 46.47±8.33 points)of the patients in the control group.The sleep efficiency index value and the rapid eye movement sleep time of the patients in the two groups had decreased significantly,but which(61.37±7.71 and 14.52±3.57%)of the patients in the study group were significantly higher than those(54.37±7.68 and 12.71±3.88%)of the patients in the control group.The arousal index valu

关 键 词：子宫肌瘤 腹腔镜全子宫切除术 低剂量艾司氯胺酮 右美托咪定 术后疼痛 睡眠质量 抑郁 焦虑 

分 类 号：R614[医药卫生—麻醉学]