艾司氯胺酮复合瑞马唑仑应用于前列腺癌根治术对麻醉效果的影响  

Effect of esketamine combined with remimazolam on anesthetic effect in radical prostatectomy for prostate cancer

作　　者：邱靖 唐智豪 蔡振 周鹏飞 QIU Jing;TANG Zhi-hao;CAI Zhen;ZHOU Peng-fei(Department of Anesthesiology,Jinhua Central Hospital,School of Medicine,Zhejiang University,Jinhua 321000,Zhejiang Province,China;Department of Urology,Jinhua Central Hospital,School of Medicine,Zhejiang University,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属金华医院/金华市中心医院麻醉科,浙江金华321000 [2]浙江大学医学院附属金华医院/金华市中心医院泌尿科,浙江金华321000

出　　处：《中国临床药理学杂志》2025年第4期472-476,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察艾司氯胺酮注射液复合瑞马唑仑注射液在前列腺癌根治术中的麻醉效果及安全性。方法将进行前列腺癌根治术的患者按照队列法分为对照组和试验组,对照组用0.2 mg·kg^(-1)瑞马唑仑注射液复合1 mg·kg^(-1)丙泊酚注射液实施麻醉诱导,试验组用0.5 mg·kg^(-1)艾司氯胺酮注射液复合0.1 mg·kg^(-1)瑞马唑仑注射液实施麻醉诱导,2组患者均用4~8 mg·kg^(-1)·h^(-1)丙泊酚注射液复合5~10μg·kg^(-1)·h^(-1)瑞芬太尼注射液进行麻醉维持。比较2组患者的镇痛效果、镇静效果、血流动力学[麻醉前(T0)、气管插管(T1)、术中30 min(T2)、术后2 h(T3)]、机体应激(T0~T3)及安全性。结果对照组和试验组各入组44例和42例。试验组术后3、6、12和24 h的数字疼痛评定量表(NRS)评分分别为(2.71±0.46)、(2.52±0.43)、(2.24±0.32)和(2.25±0.29)分,静脉自控镇痛(PCIA)用药剂量为(52.38±6.67)mL,对照组术后3、6、12和24 h的NRS评分分别为(3.49±0.52)、(3.27±0.44)、(2.73±0.41)和(2.54±0.39)分,PCIA用药剂量为(64.79±7.45)mL;试验组T1、T2、T3时心率(HR)分别为(105.48±3.34)、(102.67±3.45)和(100.29±1.93)beat·min^(-1),T1、T2时血清皮质醇(Cor)分别为(257.68±29.18)和(303.75±31.52)nmoL·L^(-1),T2、T3时血清超氧化物歧化酶(SOD)分别为(425.85±50.45)和(422.96±50.21)U·L^(-1);对照组T1、T2、T3时HR分别为(95.38±2.26)、(91.52±2.68)和(87.15±1.40)beat·min^(-1),T1、T2时血清Cor分别为(307.36±32.11)和(322.38±33.45)nmoL·L^(-1),T2、T3时血清SOD分别为(401.23±46.21)和(388.24±45.87)U·L^(-1)。试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(P<0.05,P<0.01)。试验组的药物不良反应主要有苏醒躁动、恶心呕吐,对照组的药物不良反应主要有复视、苏醒躁动、恶心呕吐。试验组和对照组的药物不良反应总发生率分别为13.64%(6例/44例)和16.67%(7例/42例),在统计学上差异无统计学意义(P>0.05)。�Objective To observe the anesthetic effect of esketamine injection combined with remimazolam injection in radical prostatectomy for prostate cancer.Methods The patients were divided into the control group and the treatment group according to cohort method.The control group was given anesthesia induction with remimazolam injection at 0.2 mg·kg^(-1)combined with propofol injection at 1 mg·kg^(-1).The treatment group was given anesthesia induction with esketamine injection at 0.5 mg·kg^(-1)combined with remimazolam injection at 0.1 mg·kg^(-1).Both groups underwent maintenance of anesthesia with propofol injection at 4-8 mg·kg^(-1)·h^(-1)combined with remifentanil injection at5-10μg·kg^(-1)·h^(-1).The analgesic effect,sedative effect,hemodynamics[before anesthesia(T0),tracheal intubation(T1),30 min after the beginning of surgery(T2),2 h after surgery(T3)],stress(T0~T3)and safety were compared between the two groups.Results The control group and the treatment group were enrolled in 44 cases and 42 cases,respectively.At 3 h,6 h,12 h and 24 h after surgery,the Numerical Rating Scale(NRS)scores of the treatment groups were 2.71±0.46,2.52±0.43,2.24±0.32 and 2.25±0.29;the dosage of patient-controlled intravenous analgesia(PCIA)was(52.38±6.67)mL.At 3 h,6 h,12 h and 24 h after surgery,NRS scores of the control group were 3.49±0.52,3.27±0.44,2.73±0.41 and 2.54±0.39;the dosage of PCIA was(64.79±7.45)mL.For the treatment group,heart rate(HR)were(105.48±3.34),(102.67±3.45)and(100.29±1.93)beat·min^(-1)from T1,T2,T3;serum cortisol(Cor)levels at T1 and T2 were(257.68±29.18)and(303.75±31.52)nmoL·L^(-1);serum superoxide dismutase(SOD)levels at T2 and T3 were(425.85±50.45)and(422.96±50.21)U·L^(-1).For the control group,HR were(95.38±2.26),(91.52±2.68)and(87.15±1.40)beats·min^(-1)from T1,T2,T3;serum Cor levels at T1 and T2 were(307.36±32.11)and(322.38±33.45)nmoL·L^(-1);serum SOD levels at T2 and T3were(401.23±46.21)and(388.24±45.87)U·L^(-1).The differences were statistically significant(all P<0.05

关 键 词：艾司氯胺酮注射液 瑞马唑仑注射液 前列腺癌根治术 镇痛 机体应激 麻醉复苏 功能恢复 

分 类 号：R614[医药卫生—麻醉学]