艾司氯胺酮不同给药方式用于腰方肌阻滞对结肠癌术后效果分析  

Analysis on the effect of different administration methods of ketamine on lumbar muscle block for postoperative colon cancer

作　　者：陈冬冬 闫书山 李海锟 白法瑞 李怀磊 CHEN Dongdong;YAN Shushan;LI Haikun;BAI Farui;LI Huailei(Department of Anesthesiology,Affiliated Hospital of Shandong Second Medical University,Shandong,Weifang 261000,China;School of Anesthesiology,Shandong Second Medical University,Shandong,Weifang 261000,China;Department of Gastroenterology,Affiliated Hospital of Shandong Second Medical University,Shandong,Weifang 261000,China;Department of Urology Surgery,Affiliated Hospital of Shandong Second Medical University,Shandong,Weifang 261000,China;Department of Anesthesiology,Pingyi County Traditional Chinese Medicine,Shandong,Pingyi 273300,China)

机构地区：[1]山东第二医科大学附属医院麻醉科,山东潍坊261000 [2]山东第二医科大学麻醉学院,山东潍坊261000 [3]山东第二医科大学附属医院胃肠外科,山东潍坊261000 [4]山东第二医科大学附属医院泌尿外科,山东潍坊261000 [5]山东省平邑县中医医院麻醉科,山东平邑273300

出　　处：《中国医药科学》2025年第3期158-163,共6页China Medicine And Pharmacy

基　　金：山东省自然科学基金(ZR2019QH012)。

摘　　要：目的 探讨艾司氯胺酮不同给药方式对结肠癌术后腰方肌阻滞效果分析。方法 选取2022年1月至2023年12月于山东第二医科大学附属医院行全麻腹腔镜结肠癌手术的患者120例,根据随机数表法分为神经阻滞组、静脉注射组和对照组,每组各40例。比较3组围手术期血流动力学、术后疼痛程度、自控镇痛泵(PCA)使用情况(术后首次PCA使用时间、48 h内PCA总次数、羟考酮辅助镇痛例数)、氧化应激指标及不良反应发生率。结果 与对照组比较,神经阻滞组和静脉注射组术后PCA首次使用时间延长,48 h内PCA总次数及羟考酮辅助镇痛例数减少,且神经阻滞组优于静脉注射组,差异有统计学意义(P <0.05)。神经阻滞组和静脉注射组术后各时间点的数字疼痛量表评分均低于对照组,且神经阻滞组低于静脉注射组,差异有统计学意义(P <0.05);神经阻滞组和静脉注射组术后各时间点的舒适度量表评分均高于对照组,且神经阻滞组高于静脉注射组,差异有统计学意义(P <0.05)。神经阻滞组和静脉注射组术后应激反应指标水平低于对照组,差异有统计学意义(P <0.05),神经阻滞组与静脉注射组术后应激反应指标水平比较,差异无统计学意义(P> 0.05)。神经阻滞组和静脉注射组术后不良反应发生率低于对照组,差异有统计学意义(P <0.05)。结论 神经周围注射艾司氯胺酮对结肠癌术后腰方肌阻滞效果优于静脉注射,能更有效延长镇痛时间,降低术后疼痛评分,提高患者舒适度且不增加应激反应和不良反应。Objective To investigate the effect of different administration methods of ketamine on lumbar muscle block for postoperative colon cancer.Methods A total of 120 patients who underwent laparoscopic colon cancer surgery under general anesthesia at the Affiliated Hospital of Shandong Second Medical University from January 2022 to December 2023 were selected and divided into the nerve block group(n=40),the intravenous injection group(n=40),and the control group(n=40).The perioperative hemodynamics,postoperative pain levels,and use of patient controlled analgesia(PCA)were compared in three groups(time of first use of PCA pump,total number of PCA uses within 48 hours,number of cases of hydrocodone assisted analgesia),oxidative stress indices,and incidence of adverse reactions(ADRs).Results Compared with the control group,the nerve block group and the intravenous injection group had a longer first use time of PCA after surgery,a lower total number of PCA uses and cases of hydrocodone assisted analgesia within 48 hours,and the nerve block group was superior to those of the intravenous injection group,with statistically significant differences(P<0.05).The numeric rating scale scores (NRS) at each time point of the nerve block group and the intravenous injection group were all lower than those of the control group, and the nerve block group was lower than the intravenous injection group, with statistically significant difference (P < 0.05). The Bruggrmann comfort scale (BCS) at each time point of the nerve block group and the intravenous injection group were all higher than those of the control group, and the nerve block group was higher than the intravenous injection group, with statistically significant differences (P < 0.05). The postoperative stress response index levels in the nerve block group and the intravenous injection group were lower than those in the control group, with statistically significant difference (P < 0.05). There was no statistically significant difference between the nerve block group and the intra

关 键 词：艾司氯胺酮 给药方式 腰方肌阻滞 应激 镇痛 

分 类 号：R614[医药卫生—麻醉学]