摘要
目的研究艾司氯胺酮复合麻醉对胸腔镜肺叶切除术患者术中血流动力学和术后镇痛的影响。方法以2020年2月-2022年3月江苏省南通市第一人民医院麻醉科就诊的102例胸腔镜肺叶切除手术患者为研究对象,采用随机数字表法分为观察组(51例)与对照组(51例)。对照组接受静吸复合麻醉,观察组接受艾司氯胺酮复合麻醉联合静吸复合麻醉,对比两组麻醉诱导前5 min(T0)、麻醉诱导后(T1)、切皮前(T2)、切皮后5 min(T3)血流动力学、脑氧摄取率(CEO-2)、血清前列腺素E-2(PGE-2)、去甲肾上腺素(NE),对比两组术后1、24、48 h的疼痛情况,对比两组麻醉相关不良反应。结果T2、T3时刻,与对照组比较,观察组心率(HR)、平均动脉压(MAP)升高,差异有统计学意义(P<0.05)。T1、T2、T3时,与对照组比较,观察组脑氧摄取率(CEO-2)降低,差异有统计学意义(P<0.05)。术后1、24、48 h,与对照组比较,观察组视觉模拟评分(VAS)降低,差异有统计学意义(P<0.05)。T1、T2、T3时,与对照组比较,观察组前列腺素E-2(PGE-2)、去甲肾上腺素(NE)水平降低,差异有统计学意义(P<0.05)。两组麻醉相关不良反应发生率相比无统计学差异(P>0.05)。结论艾司氯胺酮复合麻醉用于胸腔镜肺叶切除手术中镇痛效果明显,可维持血流动力学稳定,减轻应激反应,改善脑氧代谢,且安全可靠。
Objective investigate the effects of esketamine combined anesthesia on intraoperative hemodynamics and postoperative analgesia in patients with thoracoscopic lobectomy.Methods A total of 102 patients with thoracoscopic lobotomy treated in the Department of Anesthesiology of the hospital from February 2020 to March 2022 were selected as the research objects.The patientswere divided into observation group(51 cases)and control group(51 cases)by random number table method.The control group received intravenous infusion combined anesthesia,and the observation group received esketamine combined with intravenous infusion combined anesthesia.The hemodynamics,cerebral oxygen uptake rate(CEO-2),serum prostaglandin E-2(PGE-2)and norepinephrine(NE)of the two groups were compared 5 min before anesthesia induction(T0),after anesthesia induction(T1),before incision(T2)and 5 min after incision(T3),and the pain conditions 1,24 and 48 h after the surgery were compared between the two groups.Anesthesia related adverse reactions were compared between the two groups.Results At T2 and T3,heart rate(HR)and mean arterial pressure(MAP)in the observation group were increased compared with the control group,with statistical significance(P<0.05).At T1,T2 and T3,the cerebral oxygen uptake rate(CEO-2)of the observation group were decreased compared with the control group,and the difference was statistically significant(P<0.05).At 1 h,24 h and 48 h after the surgery,visual analog score(VAS)of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).At T1,T2 and T3,the levels of prostaglandin E-2(PGE-2)and norepinephrine(NE)in the observation group were decreased compared with the control group,and the difference was statistically significant(P<0.05).There was nodifference in the incidence of anesthesia-related adverse reactions between the two groups(P>0.05).Conclusion Esketamine combined anesthesia in thoracoscopic lobectomy has obvious analgesic effect,and itcan maintain hemodynamic stability,reduce stress response,improve cerebral oxygen metabolism,and it is safe and reliable.
作者
蔡雪姣
杜伯祥
CAI Xuejiao;DU Boxiang(Department of Anesthesiology,The First People's Hospital of Nantong,Nantong Jiangsu 226000,China)
出处
《新疆医科大学学报》
CAS
2023年第7期937-941,共5页
Journal of Xinjiang Medical University
基金
江苏省自然科学基金面上项目(BK20191207)
江苏省南通市科技项目(JC2020059)。
