亚麻醉剂量艾司氯胺酮在老年腹腔镜胆囊切除术患者中的应用  

Application of Subanesthetic Dose Esketamine in Elderly Patients Undergo⁃ing Laparoscopic Cholecystectomy

作　　者：杨延美 张新霞 李红艳 YANG Yanmei;ZHANG Xinxia;LI Hongyan(Department of Anesthesiology,Bincheng District People's Hospital,Binzhou,Shandong,256651,China;Department of Anesthesiology,Boxing Xingfu Hand and Foot Surgery Hospital,Binzhou,Shandong,256500,China)

机构地区：[1]滨州市滨城区人民医院麻醉科,山东滨州256651 [2]博兴兴福手足外科医院麻醉科,山东滨州256500

出　　处：《中外医疗》2025年第3期48-52,共5页China & Foreign Medical Treatment

摘　　要：目的 探讨老年腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者应用亚麻醉剂量艾司氯胺酮的临床效果。方法 简单随机选取2018年1月—2023年1月滨州市滨城区人民医院行LC的80例老年患者为研究对象,根据不同麻醉方式分成对照组(n=40)和研究组(n=40),对照组给予全静脉麻醉,研究组在对照组基础上给予亚麻醉剂量艾司氯胺酮,比较两组患者麻醉指标、镇痛效果、血流动力学指标、不良反应发生率。结果 研究组麻醉苏醒、拔管、定向力恢复时间均长于对照组,差异均有统计学意义(P均<0.05)。术后2 h、6 h、12 h,两组患者疼痛视觉模拟评分高于术后0.5 h,但研究组各时段疼痛评分低于对照组,差异均有统计学意义(P均<0.05)。插管时、气腹后10 min、术毕、拔管时,两组患者心率、收缩压、舒张压呈先下降后升高的趋势,且研究组各项指标高于对照组,差异均有统计学意义(P均<0.05)。研究组不良反应发生率为17.50%(7/40),与对照组的12.50%(5/40)比较,差异无统计学意义(χ^(2)=0.392,P>0.05)。结论 亚麻醉剂量艾司氯胺酮应用于老年LC患者中,虽然会延长术后苏醒及恢复时间,但能够提高镇痛效果,减轻血流动力学指标波动,不会增加不良反应的发生,安全性较高。Objective To investigate the clinical effects of laparoscopic cholecystectomy(LC)applied to subanesthetic dose esketamine for elderly patients.Methods A total of 80 elderly patients undergoing LC in Bincheng District People's Hospital of Binzhou City from January 2018 to January 2023 were simply random selected as the study ob-jects,and divided into control group(n=40)and study group(n=40)according to different anesthesia methods.The control group was given total intravenous anesthesia,and the study group was given subanesthetic dose esketamine on the basis of the control group.Anesthesia indexes,analgesic effect,hemodynamic indexes and incidence of adverse re-actions were compared between the two groups.Results The recovery time of anesthesia,extubation and orientation in the study group were longer than those in the control group,and the differences were statistically significant(all P<0.05).At 2 h,6 h and 12 h after surgery,the pain Visual Analogue Scale scores in the two groups were higher than those in 0.5 h after surgery,but the pain scores in the study group were lower than those in the control group at all times,the differences were statistically significant(all P<0.05).At the time of intubation,10 min after pneumoperito-neum,after surgery,and after extubation,the heart rate,systolic blood pressure and diastolic blood pressure of the two groups showed a trend of first decreasing and then increasing,and all indexes of the study group were higher than those of the control group,the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the study group was 17.50%(7/40),compared with 12.50%(5/40)in the control group,the difference was not statis-tically significant(χ^(2)=0.392,P>0.05).Conclusion The application of subanesthetic dose esketamine in elderly pa-tients with LC can prolong the postoperative recovery and recovery time,but it can improve the analgesic effect,reduce the fluctuation of hemodynamic indexes,and does not increase the occurrence of adverse reactions,w

关 键 词：老年患者 腹腔镜胆囊切除术 亚麻醉剂量 艾司氯胺酮 

分 类 号：R614[医药卫生—麻醉学]