摘要
目的探讨艾司氯胺酮恒速泵注对依托咪酯靶控输注患者苏醒期躁动的影响。方法选择拟在依托咪酯靶控输注全麻下行中耳鼓室成形手术的患者120例,男61例,女59例,年龄18~64岁,BMI 18~30 kg/m^(2),ASAⅠ或Ⅱ级。将患者随机分为两组:艾司氯胺酮组(E组)和对照组(C组),每组60例。麻醉诱导开始至手术结束前30 min,E组泵注艾司氯胺酮0.2 ml·kg^(-1)·h^(-1),C组泵注生理盐水0.2 ml·kg^(-1)·h^(-1)。记录手术时间、麻醉时间、苏醒时间、拔管时间、PACU停留时间。记录苏醒期躁动例数、出PACU时和术后1 d VAS疼痛评分、术后1 d恶心呕吐例数以及术后1 d恶心呕吐VAS评分。评估术前、术后1、2 d的焦虑和抑郁评分。结果E组苏醒期躁动发生率、出PACU时和术后1 d VAS疼痛评分明显低于C组(P<0.05)。两组手术时间、麻醉时间、苏醒时间、拔管时间、PACU停留时间、术后1 d恶心呕吐发生率、术后1 d恶心呕吐VAS评分以及不同时点焦虑、抑郁评分差异无统计学意义。结论艾司氯胺酮泵注辅助依托咪酯靶控输注可以减少苏醒期躁动,促进患者术后恢复。
Objective To investigate the effect of constant speed pump infusion of esmketamine on emergence agitation(EA)after target-controlled infusion of etomidate.Methods A total of 120 patients scheduled for middle ear tympanoplasty under target-controlled infusion of etomidate,61 males and 59 females,aged 18-64 years,BMI 18-30 kg/m^(2),ASA physical statusⅠorⅡ,were randomly divided into two groups:the esmketamine group(group E)and the control group(group C),60 patients in each group.From the beginning of anesthesia induction to 30 minutes before the end of operation,esmketamine 0.2 ml·kg^(-1)·h^(-1) in group E and saline injection 0.2 ml·kg^(-1)·h^(-1) in group C were injected,respectively.The operation time,anesthesia time,awakening time,extubation time,and the duration in PACU were recorded.The incidence of EA,the VAS pain scores when leaving PACU and 1 day after operation,the incidence and VAS score of nausea and vomiting 1 day after operation were evaluated.The anxiety and depression scores of the two groups were evaluated before operation,1 day and 2 days after operation.Results The incidence of EA,VAS pain score when leaving PACU and 1 day after operation in group E were significantly lower than those in group C(P<0.05).There was no significant difference in operation time,anesthesia time,awakening time,extubation time,the duration in PACU,incidence and VAS score of nausea and vomiting 1 day after operation,and the indexes of anxiety and depression at different time points between the two groups.Conclusion Esmketamine pump infusion combined with etomidate target-controlled infusion can reduce emergence agitation and promote postoperative recovery.
作者
杨玉峰
赵冰清
曾毅
YANG Yufeng;ZHAO Bingqing;ZENG Yi(Department of Anesthesiology and Perioperative Medicine,Xijing Hospital,Airforce Medical University,Xi'an 710032,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2024年第2期165-169,共5页
Journal of Clinical Anesthesiology
基金
陕西省自然科学基础研究计划重点项目(2021JZ-33)。
关键词
艾司氯胺酮
依托咪酯
苏醒期躁动
靶控输注
Esmketamine
Etomidate
Emergence agitation
Target-controlled infusion
