妇科腹腔镜手术中辅助应用小剂量艾司氯胺酮复合右美托咪定的效果  

Effect of Adjuvant Application of Low Dose Esketamine Combined with Dexmedetomidine in Gynecological Laparoscopic Surgery

作　　者：叶敏 魏海翔 姜闽英 YE Min;WEI Haixiang;JIANG Minying(Department of Anesthesiology,the First Hospital of Nanping,Nanping 353000,China;不详)

机构地区：[1]南平市第一医院麻醉科,福建南平353000

出　　处：《中国医学创新》2025年第8期117-120,共4页Medical Innovation of China

摘　　要：目的:探究与分析在妇科腹腔镜手术中辅助应用小剂量艾司氯胺酮复合右美托咪定的效果。方法:采取随机数字表法对南平市第一医院2023年9月—2024年3月收治的实施妇科腹腔镜手术患者90例进行分组,每组45例。两组采取相同方案进行麻醉诱导,对照组持续泵入右美托咪定维持麻醉,观察组在对照组基础上加用小剂量艾司氯胺酮维持麻醉。对比两组围手术期收缩压(SBP)、平均动脉压(MAP)、心率(HR)、经皮动脉血氧饱和度(SpO_(2)),记录两组麻醉恢复情况及不良反应。结果:观察组插管时、插管后5 min、气腹时、拔管后5 min的SBP、MAP、HR均明显低于对照组(P<0.05);两组不同时点SpO_(2)比较,差异均无统计学意义(P>0.05)。与对照组相比,观察组意识恢复时间、拔管时间及定向力恢复时间均早,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:妇科腹腔镜手术中应用小剂量艾司氯胺酮复合右美托咪定可维持患者围手术期血流动力学稳定,缩短麻醉后恢复时间,且安全性高。Objective:To explore and analyze the effect of adjuvant application of low dose Esketamine combined with Dexmedetomidine in gynecological laparoscopic surgery.Method:A total of 90 patients underwent gynecological laparoscopic surgery admitted to the First Hospital of Nanping from September 2023 to March 2024 were grouped by random number table method,with 45 cases in each group.The two groups adopted the same scheme for anesthesia induction,the control group was continuously pumped with Dexmedetomidine to maintain anesthesia,and the observation group was additionally injected with low dose Esketamine to maintain anesthesia.Perioperative systolic blood pressure(SBP),mean arterial pressure(MAP),heart rate(HR)and percutaneous arterial oxygen saturation(SpO_(2))were compared between the two groups,and anesthesia recovery and adverse reactions were recorded in the two groups.Result:The SBP,MAP and HR in observation group were significantly lower than those in control group at intubation,5 min after intubation,pneumoperitoneum and 5 min after extubation(P<0.05).There were no significant differences in SpO_(2) between the two groups at different time points(P>0.05).Compared with the control group,the consciousness recovery time,extubation time and orientation recovery time of the observation group were earlier,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of low dose Esketamine combined with Dexmedetomidine in gynecological laparoscopic surgery can maintain the hemodynamic stability of patients during perioperative period,shorten the recovery time after anesthesia,and have high safety.

关 键 词：妇科腹腔镜手术 艾司氯胺酮 右美托咪定 不良反应 

分 类 号：R61[医药卫生—外科学]