艾司氯胺酮用于老年手术患者全麻诱导中的临床效果观察  

Observation of clinical effect of esketamine during induction of general anesthesia in elderly surgical patients

作　　者：陈文玲 谭志林 郑德志 李显立 CHEN Wen-ling;TAN Zhi-lin;ZHENG De-zhi(Anesthesia Surgery Center,Xinxing County People's Hospital,Yunfu 527400,China)

机构地区：[1]新兴县人民医院麻醉手术中心,527400

出　　处：《中国实用医药》2025年第5期109-112,共4页China Practical Medicine

基　　金：云浮市医药卫生科研立项(项目编号:2022B082)

摘　　要：目的探讨艾司氯胺酮用于老年手术患者全身麻醉(全麻)诱导中的临床效果。方法将实施全麻手术的100例老年患者随机分为观察组及对照组,各50例。观察组在全麻诱导中使用艾司氯胺酮,对照组在全麻诱导中使用等量生理盐水。比较两组不同时刻[麻醉诱导前(T1)、气管插管前即刻(T2)、声门暴露即刻(T3)、气管插管后即刻(T4)、插管后3min(T5)、插管后5min(T6)]的血流动力学指标[平均动脉压(MAP)、心率(HR)、收缩压(SBP)、舒张压(DBP)]水平,苏醒指标[苏醒时间、拔管时间、定向力恢复时间、麻醉后监测治疗室(PACU)停留时间],不良反应发生情况。结果观察组T2~T6时的MAP、HR、SBP、DBP均低于对照组(P<0.05)。观察组苏醒时间、拔管时间、定向力恢复时间、PACU停留时间分别为(12.01±2.83)、(13.26±2.78)、(9.79±2.34)、(30.42±5.23)min,均短于对照组的(14.75±2.52)、(16.68±3.01)、(11.98±2.16)、(41.45±6.87)min(P<0.05)。观察组不良反应发生率8.00%低于对照组的32.00%(P<0.05)。结论艾司氯胺酮用于老年手术患者全麻诱导中的临床效果显著,能稳定术中血流动力学,缩短苏醒时间,减少不良反应。Objective To explore the clinical effect of esketamine during induction of general anesthesia in elderly surgical patients.Methods 100 elderly patients undergoing general anesthesia were randomly divided into an observation group and a control group,with 50 cases in each group.The observation group received esketamine during induction of general anesthesia,and the control group received the same amount of normal saline during induction of general anesthesia.Both groups were compared in terms of hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)]at different time points[before anesthesia induction(T1),immediately before tracheal intubation(T2),immediately after glottis exposure(T3),immediately after tracheal intubation(T4),3 min after intubation(T5),and 5 min after intubation(T6)],recovery indexes[recovery time,extraction time,orientation recovery time,length of post-anesthesia care unit(PACU)stay after anesthesia],and the occurrence of adverse reactions.Results MAP,HR,SBP and DBP in the observation group were lower than those in the control group at T2-T6(P<0.05).The recovery time,extubation time,orientation recovery time and length of PACU stay in the observation group were(12.01±2.83),(13.26±2.78),(9.79±2.34)and(30.42±5.23)min,which were shorter than(14.75±2.52),(16.68±3.01),(11.98±2.16)and(41.45±6.87)min in the control group(P<0.05).The incidence of adverse reactions of 8.00%in the observation group was lower than 32.00%in the control group(P<0.05).Conclusion Esketamine shows significant clinical effect during induction of general anesthesia in elderly surgical patients,and can stabilize intraoperative hemodynamics,shorten recovery time and reduce adverse reactions of patients.

关 键 词：老年 手术 全身麻醉诱导 艾司氯胺酮 临床效果 

分 类 号：R61[医药卫生—外科学]