摘要
艾司氯胺酮作为氯胺酮的纯右旋异构体,与氯胺酮相比,它与N-甲基-d-天冬氨酸(NMDA)受体和阿片μ受体的亲和力更高,在临床麻醉镇痛效果和抗抑郁作用中具有独特的优势。与经典静脉注射氯胺酮相比,艾司氯胺酮具有更强的镇静镇痛效果、对患者呼吸抑制影响小、维持术中血流动力学稳定、缩短患者术后苏醒时间等优点,因此常用于静脉麻醉、小儿麻醉和产科麻醉中。此外,艾司氯胺酮还具有与氯胺酮相似的快速抗抑郁作用,应用于治疗重症、难治性抑郁症,且可能更安全有效,为临床抑郁障碍的治疗提供了新选择。本文主要就艾司氯胺酮的药理学特性、临床运用研究进展和不良反应进行综述,介绍艾司氯胺酮在麻醉镇痛领域和抗抑郁作用中的临床运用,以期为艾司氯胺酮临床使用提供借鉴和参考,并提供新的研究方向。
Esketamine,as a pure dextral isomer of Ketamine,has a higher affinity with N-methyl-D-aspwhcacid(NMDA)receptors and opioidμreceptors than Ketamine,and has unique advantages in clinical analgesic and antidepressant effects.Compared with classical intravenous Ketamine,Esketamine has stronger sedative and analgesic effect,less influence on patients'respiratory depression,maintain intraoperative hemodynamic stability,shorten patients'postoperative recovery time and other advantages,so it is often used in intravenous anesthesi,pediatric anesthesia and obstetric anesthesia.In addition,Esketamine also has a similar rapid antidepressant effect to Ketamine,which is suitable for the treatment of severe and refractory depression,and may be safer and more effective,providing a new option for the treatment of clinical depression disorders.This article mainly reviews the research progress and adverse reactions of the clinical application of Esketamine,introduces the clinical application of Esketamine in the field of anesthesia,analgesia and anti-depression,in order to provide reference for the clinical use of Esketamine,and provide a new research direction.
作者
刘瑞
但伶
LIU Rui;DAN Ling(Department of Anesthesiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing400010,China)
出处
《中国当代医药》
CAS
2023年第23期28-32,共5页
China Modern Medicine
关键词
艾司氯胺酮
临床应用
麻醉药物
精神药物
Esmketamine
Clinical application
Anaesthetic
Psychotropic drug
