目的 探讨腹腔镜胆囊切除术麻醉诱导使用艾司氯胺酮亚麻醉剂量的具体效果.方法 随机选择2023年1-6月山东省烟台市北海医院收治的100例须择日行腹腔镜胆囊切除术的患者作为研究对象,按照区组随机法分为参照组(n=50,安慰剂麻醉诱导)、探讨组(n=50,亚麻醉剂量艾司氯胺酮麻醉诱导),比较两组患者麻醉诱导效果.结果 T1期探讨组患者心率、舒张压、收缩压高于参照组,差异有统计学意义(P均＜0.05);探讨组麻醉苏醒时间、拔管时间、定向力恢复时间、术后恢复室(Post-Anesthesia Care Unit,PACU)停留时间短于参照组,差异有统计学意义(P均＜0.05);探讨组患者术后30 min、术后2 h、术后6 h Ramsay镇静量表(Ramsay Sedation Scale,RSS)评分高于参照组,差异有统计学意义(P均＜0.05);探讨组术后30 min、术后2 h、术后6 h疼痛数字评分量表(Numerical Rating Scale,NRS)评分(1.26±0.27)分、(1.65±0.39)分、(2.80±0.42)分低于参照组,差异有统计学意义(t=26.058、18.494、5.847,P均＜0.05);拔管后探讨组患CD3+、CD4+、CD4+/CD8+指标高于参照组,CD8+指标低于参照组,差异有统计学意义(P均＜0.05).结论 在常规麻醉诱导基础上配合亚麻醉剂量艾司氯胺酮,能显著稳定腹腔镜胆囊切除术患者血流动力学水平,改善麻醉效果,镇静、镇痛效果显著,对患者免疫功能影响更小.
Clinical Effect of Subanesthetic Dose Esketamine on Anesthesia Induction in Laparoscopic Cholecystectomy
Objective To investigate the specific effect of anesthesia induction with subanesthetic dose esketamine in laparoscopic cholecystectomy.Methods A total of 100 patients requiring laparoscopic cholecystectomy treated in Bei-hai Hospital of Yantai,Shandong Province from January to June 2023 were randomly selected as the study objects and divided into the reference group(n=50,induced by placebo anesthesia)and the exploration group(n=50,induced by subanesthetic dose esketamine anesthesia)according to block randomization method,and the anesthetic induction ef-fects of the two groups were compared.Results The heart rate,diastolic blood pressure and systolic blood pressure in the exploration group were higher than those in the reference group at T1 stage,and the differences were statistically significant(all P＜0.05).The anesthesia recovery time,extubation time,orientation recovery time and Post-anesthesia Care Unit(PACU)stay time in the exploration group were shorter than those in the reference group,and the differ-ences were statistical significance(all P＜0.05).The Ramsay Sedation Scale(RSS)scores in the study group were higher than those in the reference group at 30 min,2 h and 6 h after surgery,and the differences were statistically sig-nificant(all P＜0.05).Numerical Rating Scale(NRS)scores(1.26±0.27)points,(1.65±0.39)points and(2.80±0.42)points in the study group at 30 min,2 h and 6 h after surgery were lower than those in the reference group.The differ-ence was statistically significant(t=26.058,18.494,5.847,all P＜0.05).After extubation,the indexes of CD3+,CD4+,CD4+/CD8+ in the study group were higher than those in the reference group,and the indexes of CD8+ was lower than that in the reference group,and the differences were statistical significance(all P＜0.05).Conclusion Combined with the subanesthetic dose of esketamine on the basis of conventional anesthesia induction,it can significantly stabilize the hemodynamic level of patients with laparoscopic cholecystectomy,improve the anesthetic effect,and have more significant sedative and analgesic effects,with less impact on the immune function of patients.
EsketamineSubanesthetic doseInduction of anesthesiaLaparoscopic cholecystectomy
万方数据
维普
