艾司氯胺酮联合丙泊酚用于小儿短小手术的安全性及有效性研究  

Study on safety and efficacy of Esketamine combined with propofol in pediatric short operations

作　　者：张岩 任应斌 薛孟 田瑞丽 王伟进 Zhang Yan;Ren Yingbin;Xue Meng;Tian Ruili;Wang Weijin(Changzhi Medical College,Changzhi,Shanxi 046000,China;Department of Anesthesiology,Maternal and Child Health Care Service Center,Changzhi,Shanxi 046000,China)

机构地区：[1]长治医学院,山西长治046000 [2]妇幼保健院麻醉科,山西长治046000

出　　处：《齐齐哈尔医学院学报》2025年第4期332-337,共6页Journal of Qiqihar Medical University

基　　金：山西省医师协会临床科研项目(YSXH-RF2022MZ007)。

摘　　要：目的 评价艾司氯胺酮联合丙泊酚用于小儿短小手术全身麻醉的有效性及安全性。方法 选择2023年1—12月于本院在全身麻醉下行短小手术的80例患儿作为研究对象,随机分为观察组(O组)和对照组(C组)两组,每组各40例。O组采用丙泊酚+艾司氯胺酮+苯磺酸顺阿曲库铵麻醉诱导,术中丙泊酚+艾司氯胺酮麻醉维持;C组采用丙泊酚+舒芬太尼+苯磺酸顺阿曲库铵麻醉诱导,术中丙泊酚+瑞芬太尼麻醉维持。观察比较一般资料指标情况;入室时(T0)、插管时(T1)、手术切皮时(T2)、拔管时(T3)的血流动力学指标变化情况;复苏期情况以及术后不良反应发生率情况。结果 与C组相比较,O组患儿在T1、T2、T3时刻的心率、血压明显升高,差异具有统计学意义(P<0.05)。各组组内比较:与T0相比,两组患儿T3的心率、血压均升高;O组患儿T1、T2的心率、血压较T0明显增高;C组患儿T2的心率较T0降低,差异均具有统计学意义(均P<0.05);O组患儿在拔管后10 min、30 min和60 min的术后疼痛评分、苏醒后10 min、30 min和60 min的术后苏醒期躁动评分及术后恶心呕吐和呼吸抑制发生率均小于C组,差异均具有统计学意义(均P<0.05)。两组患儿一般指标情况及复苏期指标情况相比较,差异均无统计学意义(均P>0.05)。结论 艾司氯胺酮联合丙泊酚可安全有效于小儿短小手术,减轻术后不良反应,提高麻醉复苏质量。Objective To evaluate the efficacy and safety of esketamine combined with propofol in general anesthesia for pediatric short operations.Methods A total of 80 children who underwent short operations under general anesthesia in our hospital from January 2023 to December 2023 were selected as study subjects.The subjects were randomly divided into an observation group(Group O)and a control group(Group C),with 40 participants in each group.Group O received anesthesia induction with propofol+esketamine+cisatracurium benzenesulfonate and anesthesia maintenance with propofol+esketamine.Group C received anesthesia induction with propofol+sufentanil+cisatracurium benzenesulfonate and anesthesia maintenance with propofol+remifentanil.The study compared general data indicators,changes in hemodynamic indices at entry(T0),intubation(T1),surgical incision(T2),and extubation(T3),as well as the situation during the recovery period and the incidence of postoperative adverse reactions.Results Compared with Group C,Group O exhibited significantly higher heart rates and blood pressures at T1,T2,and T3,with statistically significant differences(P<0.05).In intra-group comparisons,both groups showed increased heart rates and blood pressures at T3 compared to T0.Group O had significantly higher heart rates and blood pressures at T1 and T2 compared to T0,while Group C had a lower heart rate at T2 compared to T0,with all differences being statistically significant(P<0.05).Group O had lower postoperative pain scores at 10 min,30 min,and 60 min after extubation,lower postoperative agitation scores at 10 min,30 min,and 60 min after recovery,and lower incidences of postoperative nausea,vomiting,and respiratory depression,all with statistical significance(P<0.05).There were no significant differences in general indices and recovery stage indices between the two groups(P>0.05).Conclusions Esketamine combined with propofol is safe and effective for pediatric short operations,reducing postoperative adverse reactions and improving the quality of an

关 键 词：艾司氯胺酮 全身麻醉 小儿 苏醒期躁动 疼痛 

分 类 号：R726.1[医药卫生—儿科]