不同剂量艾司氯胺酮对行腹腔镜疝囊高位结扎术患儿的临床研究  

Clinical trial of different doses of esketamine in children undergoing laparoscopic high hernia sac ligation

作　　者：汪俊 张伶俐 刘俊霞 孙盈盈 WANG Jun;ZHANG Ling-li;LIU Jun-xia;SUN Ying-ying(Department of Anesthesiology,Anhui Children's Hospital,Hefei 230051,Anhui Province,China)

机构地区：[1]安徽省儿童医院麻醉科,安徽合肥230051

出　　处：《中国临床药理学杂志》2025年第1期40-44,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的分析不同剂量艾司氯胺酮用于学龄期儿童腹腔镜疝囊高位结扎术的效果及安全性。方法将行腹腔镜疝囊高位结扎术治疗的学龄期患儿按照队列法分为小剂量组和常规剂量组。常规剂量组给予静脉注射0.75mg·kg^(-1)盐酸艾司氯胺酮注射液进行诱导前准备;小剂量组给予静脉注射0.50mg·kg^(-1)盐酸艾司氯胺酮注射液进行诱导前准备,2组患儿均进行相同麻醉诱导、麻醉维持及术后镇痛给药。观察2组患儿的苏醒时间、拔除喉罩时间、麻醉恢复室滞留时间、儿童疼痛行为量表(FLACC)评分,并记录入室时(T1)、麻醉诱导前(T2)、喉罩置入即刻(T3)的血流动力学指标,并进行安全性评价。结果常规剂量组和小剂量组分别入组39和43例患儿。治疗后,常规剂量组和小剂量组的苏醒时间分别为(26.36±3.91)和(23.21±3.55)min,拔除喉罩时间分别为(13.02±2.15)和(12.24±2.30)min,麻醉恢复室(PACU)滞留时间分别为(37.23±5.64)和(32.11±5.36)min,儿童疼痛行为量表(FLACC)评分分别为(2.08±0.45)和(2.16±0.51)分;T1、T2、T3时,常规剂量组的心率(HR)分别为(99.23±15.78)、(102.19±17.20)和(118.30±14.96)beat·min^(-1),小剂量组的HR分别为(99.93±16.27)、(103.28±16.75)和(120.19±15.39)beat·min^(-1),常规剂量组的平均动脉压(MAP)分别为(84.56±7.22)、(85.92±6.96)和(89.89±7.02)mmHg,小剂量组的MAP分别为(84.88±6.87)、(86.16±6.45)和(91.12±7.31)mmHg,小剂量组的苏醒时间、PACU滞留时间与常规剂量组比较,在统计学上差异均有统计学意义(均P<0.05)。2组患儿的药物不良反应主要有恶心呕吐、分泌物增加和一过性血压升高,常规剂量组和小剂量组的药物不良反应总发生率分别为10.26%和4.65%,在统计学上差异无统计学意义(P>0.05)。结论小剂量盐酸艾司氯胺酮注射液应用于行腹腔镜疝囊高位结扎术学龄期患儿的术前静脉给药中,可有效维持血流动力学稳定,对减轻术后Objective To analyze the efficacy and safety of different doses of esketamine for laparoscopic high hernia sac ligation in school-age children.Methods The school-age children who underwent laparoscopic high ligation of hernia sac were divided into small-dose group and conventional-dose group according to cohort method.The conventional-dose group was given intravenous 0.75 mg·kg^(-1) esketamine hydrochloride injection to prepare for induction;the small-dose group was given intravenous O.50 mg kg^(-1)esketamine hydrochloride injection to prepare for induction,and the two groups were given the same anesthesia induction,anesthesia maintenance and postoperative analgesia.The recovery time,laryngeal mask removal time,anesthesia recovery room residence time,children face,legs,activity,cry,consolability behavioral tool(FLACC)score of the children in the two groups were observed,the hemodynamic indexes were recorded at the time of entry(T1),before anesthesia induction(T2),immediately after laryngeal mask placement(T3),and the safety was evaluated.Results A total of 39 cases and 43 cases children were included in the conventional-dose group and the small-dose group,respectively.After treatment,the recovery time of conventional-dose group and small-dose group were(26.36±3.91)and(23.21±3.55)min;the time of removing laryngeal mask were(13.02±2.15)and(12.24±2.30)min;the retention time of postanesthesia care unit(PACU)were(37.23±5.64)and(32.11±5.36)min;the scores of FLACC were(2.08±0.45)and(2.16±0.51)points,respectively.At T1,T2 and T3,the heart rate(HR)of the conventional-dose group were(99.23±15.78),(102.19±17.20)and(118.30±14.96)beat·min^(-1);that of the small-dose group were(99.93±16.27),(103.28±16.75)and(120.19±15.39)beat·min^(-1)respectively.The mean arterial pressure(MAP)of the conventional-dose group were(84.56±7.22),(85.92±6.96)and(89.89±7.02)mmHg;that of the small-dose group were(84.88±6.87),(86.16±6.45)and(91.12±7.31)mmHg,respectively.There were statistically significant differences in the reco

关 键 词：盐酸艾司氯胺酮注射液 腹腔镜疝囊高位结扎术 学龄期 麻醉诱导 躁动 疼痛 

分 类 号：R971[医药卫生—药品]