小剂量艾司氯胺酮超前镇痛对胸外手术患者术后镇痛及认知功能的影响  

Effect of low-dose Esketamine preemptive analgesia on postoperative analgesia and cognitive function in patients undergoing external thoracic surgery

作　　者：熊江琴[1] 范励侦[1] 黎秋炎 谢信文 邓新洪 XIONG Jiangqin;FAN Lizhen;LI Qiuyan;XIE Xinwen;DENG Xinhong(Department of Anesthesiology,Jiangxi Chest Hospital,Jiangxi Province,Nanchang 330006,China;Jiangxi Taihe Health Comprehensive Supervision and Law Enforcement Bureau,Jiangxi Province,Ji'an 343700,China)

机构地区：[1]江西省胸科医院麻醉科,江西南昌330006 [2]江西泰和卫生健康综合监督执法局,江西吉安343700

出　　处：《中国当代医药》2025年第11期82-86,共5页China Modern Medicine

基　　金：江西省中医药管理局科技计划项目(2023B0310)。

摘　　要：目的探讨小剂量艾司氯胺酮超前镇痛用于胸外手术的术后镇痛及认知功能的效果。方法选取2022年1月至2024年3月江西省胸科医院收治的100例胸外手术患者作为研究对象,按照抽签法分为对照组和研究组,每组50例。两组患者进行麻醉诱导后20 min,对照组给予生理盐水,研究组给予小剂量艾司氯胺酮超前镇痛,比较两组患者不同时间点生命体征指标(平均动脉压、心率、血氧饱和度、脑电双频指数)、围手术期观察指标、镇静评分、疼痛评分以及认知功能评分情况。结果两组患者麻醉前、术中平均动脉压、心率等指标比较,差异无统计学意义(P>0.05)。研究组术中脑电双频指数高于对照组,拔管时间短于对照组,差异有统计学意义(P<0.05)。两组患者麻醉时间、术中出血量比较,差异无统计学意义(P>0.05)。研究组术后不同时间点Ramsay镇静评分、简易智力状态检查量表评分均高于对照组,视觉模拟评分法评分低于对照组,差异有统计学意义(P<0.05)。结论小剂量艾司氯胺酮超前镇痛用于胸外手术效果良好,可提升术后恢复速度,提升认知功能,获得更加理想的镇痛、镇静效果,值得推荐。Objective To investigate the effect of low dose Esketamine preemptive analgesia on postoperative analgesia and cognitive function in external thoracic surgery.Methods A total of 100 patients with external thoracic surgery admitted to Jiangxi Chest Hospital from January 2022 to March 2024 were selected as the research objects,and they were divided into control group and study group according to lottery method,with 50 cases in each group.Twenty minutes after anesthesia induction,the control group was given normal saline,and the study group was given low-dose Esketamine preemptive analgesia.The vital signs indexes(mean arterial pressure,heart rate,blood oxygen saturation,bispectral index),perioperative observation indexes,sedation scores,pain scores and cognitive function scores of the two groups were compared at different time points.Results There were no significant differences in mean arterial pressure and heart rate between the two groups before anesthesia and during operation(P>0.05).The intraoperative bispectral index of the study group was higher than that of the control group,and the extubation time was shorter than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in anesthesia time and intraoperative blood loss between the two groups(P>0.05).Ramsay sedation scale score and mini-mental state examination score in the study group were higher than those in the control group,and visual analogue score was lower than that in the control group at different time points after surgery,the differences were statistically significant(P<0.05).Conclusion Low-dose Esketamine preemptive analgesia is effective in external thoracic surgery,can improve postoperative recovery speed,improve cognitive function,and obtain more ideal analgesic and sedative effects,which is worth recommending.

关 键 词：小剂量艾司氯胺酮 超前镇痛 胸外手术 术后镇痛 认知功能 

分 类 号：R614[医药卫生—麻醉学]