摘要
目的探讨腹腔镜胆囊切除术患者预防性应用艾司氯胺酮对血流动力学、镇静效果、疼痛及应激反应的影响。方法根据随机数字表法将2024年2月至2024年11月于我院就诊的92例ASAⅠ-Ⅱ级腹腔镜胆囊切除术患者分为传统组(46例)和观察组(46例),观察组预防性给予艾司氯胺酮注射,传统组给予等量的生理盐水注射,对比两组气腹后(T1)和拔除喉罩后(T2)血流动力学指标,以及拔除喉罩10min、30min后镇静镇痛效果、手术前及术后24h应激反应、不良反应。结果观察组的气腹后(T1)和拔除喉罩后(T2)的心率、平均动脉压均低于传统组(P<0.05);两组的手术时间、麻醉时间、苏醒时间比较无差异(P>0.05);观察组拔除喉罩10min、30min后的RSS评分高于传统组(P<0.05)、VAS评分低于传统组(P<0.05);观察组的术后24h去甲肾上腺素(NE)、皮质醇(Cor)水平均低于传统组(P<0.05);观察组的寒战发生率低于传统组(P<0.05)。结论腹腔镜胆囊切除术患者预防性应用艾司氯胺酮能够提高镇痛、镇静效果,稳定血流动力学,减轻应激反应,防止术后寒战发生。
Objective To investigate the effect of prophylactic application of esketamine on hemodynamics,sedation,pain,and stress response in patients undergoing laparoscopic cholecystectomy.Methods According to the random number table method,92 ASA I-II patients scheduled for laparoscopic cholecystectomy in our hospital from February 2024 to November 2024 were divided into a conventional group(46 cases)and an observation group(46 cases).The observation group received prophylactic esketamine injection,while the conventional group received an equivalent volume of saline injection.Hemodynamic indicators were compared between the two groups at post-pneumoperitoneum(T1)and post-laryngeal mask removal(T2),as well as sedation and analgesia effects at 10min and 30min after laryngeal mask removal,stress response before and 24h after surgery,and adverse reactions.Results The heart rate and mean arterial pressure in the observation group at T1 and T2 were lower than those in the conventional group(P<0.05).There was no significant difference in operative time,anesthesia time,or recovery time between the two groups(P>0.05).The RSS scores in the observation group at 10min and 30min after laryngeal mask removal were higher than those in the conventional group(P<0.05).The VAS scores in the observation group at 10min and 30min after laryngeal mask removal were lower than those in the conventional group(P<0.05).The levels of norepinephrine(NE)and cortisol(Cor)24h after surgery in the observation group were lower than those in the conventional group(P<0.05).The incidence of shivering in the observation group was lower than that in the conventional group(P<0.05).Conclusion Prophylactic use of esketamine in patients undergoing laparoscopic cholecystectomy can improve analgesia and sedation,stabilize hemodynamics,reduce stress response and prevent postoperative chills.
作者
刘新法
于大朋
赵钰龙
栾春梅
马鹏
LIU Xin-fa;YU Da-peng;ZHAO Yu-long;LUAN Chun-mei;MA Peng(The Affiliated Taizhou People’s Hospital of Nanjing Medical University,Taizhou Jiangsu 225300;Affiliated Hospital of Jiangsu University,Zhengjiang Jiangsu 212001,China)
出处
《泰州职业技术学院学报》
2025年第5期90-93,共4页
Journal of Taizhou Polytechnic College
