摘要
目的比较艾司氯胺酮与舒芬太尼用于腹腔镜下输卵管切除术治疗输卵管妊娠患者的麻醉效果及安全性。方法采用前瞻性研究,选取2023年7月—2025年4月聊城市第二人民医院收治的腹腔镜下输卵管切除术患者90例,按照麻醉方案分为艾司氯胺酮组(E组,45例)和舒芬太尼组(S组,45例)。比较两组血流动力学参数、术后疼痛程度及不良反应发生率。结果两组平均动脉压(MAP)、心率(HR)组间、时间、交互作用比较,差异有统计学意义(P<0.05);麻醉诱导后(T1)、喉罩置入即刻(T2)、气腹前(T3)、气腹后(T4)时刻,E组MAP、HR低于S组,差异有统计学意义(P<0.05);两组脑电双频指数(BIS)时间、交互作用比较,差异有统计学意义(P<0.05);两组BIS比较,差异无统计学意义(P>0.05)。两组视觉模拟评分法(VAS)评分组间、时间、交互作用比较,差异有统计学意义(P<0.05);拔管后30 min、6 h、12 h、24 h、48 h,E组VAS评分均低于S组,差异有统计学意义(P<0.05)。E组不良反应总发生率低于S组,差异有统计学意义(P<0.05)。结论艾司氯胺酮在腹腔镜下输卵管切除术中表现出更稳定的血流动力学、更优的术后镇痛效果和更低的不良反应发生率,是一种安全有效的麻醉选择。
Objective To compare the anesthetic eff ect and safety of esketamine and sufentanil in patients with tubal pregnancy undergoing laparoscopic tubal pregnancy resection.Methods A prospective study was conducted.A total of 90 patients who underwent laparoscopic tubal pregnancy resection in Liaocheng Second People′s Hospital from July 2023 to April 2025 were selected and randomly divided into the esketamine group(Group E,n=45)and the sufentanil group(Group S,n=45)according to the anesthesia protocol.The hemodynamic parameters,postoperative pain degree and incidence of adverse reactions of the two groups were compared.Results There were statistically signifi cant diff erences in mean arterial pressure(MAP)and heart rate(HR)between the two groups in terms of between-group,time and interaction(P<0.05).After anesthesia induction(T1),immediately after laryngeal mask insertion(T2),before pneumoperitoneum(T3),and after pneumoperitoneum(T4),the MAP and HR in group E were lower than those in group S,and the difference was statistically significant(P<0.05).There was a statistically signifi cant diff erence in the bispectral index(BIS)of the two groups in terms of time and interaction(P<0.05).There was no statistically signifi cant diff erence in BIS between the two groups(P>0.05).There were statistically signifi cant diff erences in the Visual Analogue Scale(VAS)scores between the two groups in terms of inter-group,time and interaction(P<0.05).The VAS scores of group E at 30 minutes,6 hours,12 hours,24 hours and 48 hours after extubation were all lower than those of group S,and the diff erence was statistically signifi cant(P<0.05).The total incidence of adverse reactions in group E was lower than that in group S,and the diff erence was statistically signifi cant(P<0.05).Conclusion Esketamine shows more stable hemodynamics,better postoperative analgesic eff ect and lower incidence of adverse reactions in laparoscopic tubal pregnancy resection.It is a safe and eff ective anesthesia option and is worthy of clinical reference.
作者
郭胜男
靳亭亭
张丽
GUO Shengnan;JIN Tingting;ZHANG Li(Anesthesiology Department,Qilu Hospital,Shandong University,Jinan Shandong,250012,China;Anesthesiology Department,Liaocheng Second People's Hospital,Liaocheng Shandong,252601,China)
出处
《中华养生保健》
2025年第22期59-63,共5页
CHINESE HEALTH CARE
