艾司氯胺酮应用于老年患者下肢骨科手术麻醉中的有效性及安全性  

Efficacy and Safety of Esketamine in Anesthesia for Lower Extremity Orthopedic Surgery in Elderly Patients

作　　者：刘建秀[1] LIU Jianxiu(Department of Anesthesiology,Jinan Third People's Hospital of Shandong Province,Jinan,Shandong,250132,China)

机构地区：[1]山东省济南市第三人民医院麻醉科,山东济南250132

出　　处：《中外医疗》2025年第5期79-82,共4页China & Foreign Medical Treatment

摘　　要：目的探讨艾司氯胺酮应用于老年患者下肢骨科手术麻醉中的有效性和安全性。方法方便选取2023年1月—2024年1月山东省济南市第三人民医院治疗的98例行下肢骨科手术的老年患者为研究对象,按照不同药物麻醉诱导分组。对照组(49例)实施丙泊酚+芬太尼麻醉诱导,观察组(49例)实施丙泊酚+艾司氯胺酮麻醉诱导,对比两组应激反应指标、麻醉质量和苏醒质量指标、术后疼痛情况、麻醉不良反应发生率。结果观察组手术开始后15 min时应激反应指标水平、术后6 h、12 h疼痛评分和不良反应总发生率低于对照组,差异均有统计学意义(P均<0.05)。观察组自主呼吸恢复时间、苏醒时间为(23.25±6.27)s、(10.15±2.27)min,均低于对照组的(93.65±15.18)s、(14.05±3.39)min,差异均有统计学意义(t=30.005,6.691;P均<0.05)。结论老年患者下肢骨科麻醉手术中艾司氯胺酮可减轻应激反应,提高麻醉质量和苏醒质量,缓解疼痛,安全性较高。Objective To investigate the efficacy and safety of esketamine in anesthesia of lower extremity orthopedic surgery in elderly patients.Methods From January 2023 to January 2024,98 elderly patients who underwent lower limb orthopedic surgery in Jinan Third People's Hospital of Shandong Province were convenient selected as the research objects,and were grouped according to different drug anesthesia induction.The control group(49 cases)was induced by propofol+fentanyl anesthesia,and the observation group(49 cases)was induced by propofol+esketamine anesthesia.The stress response indexes,anesthesia quality and recovery quality indexes,postoperative pain and the incidence of adverse reactions of anesthesia were compared between the two groups.Results The level of stress response index at 15 min after operation,pain score at 6 h and 12 h after operation and total incidence of adverse reactions in the observation group were lower than those in the control group,and the differences were statistically significant(all P0.05).The spontaneous breathing recovery time and recovery time of the observation group were(23.25±6.27)s and(10.15±2.27)min,which were lower than(93.65±15.18)s and(14.05±3.39)min of the control group,and the differences were statistically significant(t=30.005,6.691;both P<0.05).Conclusion Esketamine can reduce stress response,improve the quality of anesthesia and recovery,relieve pain and has high safety in elderly patients undergoing lower limb orthopedic anesthesia.

关 键 词：老年下肢骨科手术 艾司氯胺酮 麻醉有效性 麻醉安全性 

分 类 号：R614[医药卫生—麻醉学]