Clinical Value of Subanesthetic Dose of Esketamine Combined with Ultrasound-assisted Paraspinal Block in Patients Undergoing Thoracoscopic Surgery
Objective To explore the clinical value of subanesthetic dose of Esketamine combined with ultrasound-assisted paraspinal block in patients undergoing thoracoscopic surgery.Methods A total of 308 patients scheduled for thora-coscopic surgery from December 2022 to March 2024 were selected and randomly divided into the Esketamine group(n=154)and the control group(n=154),according to random number table method.Both groups underwent ultrasound-guided pa-raspinal block under general anesthesia.The Esketamine group received an intravenous injection of 0.1 mg/kg Esketamine combined with ultrasound-guided paraspinal block,while the control group received an intravenous injection of an equivalent amount of 0.9%sodium chloride solution combined with ultrasound-guided paraspinal block.The visual analogue scale(VAS)pain scores at rest and during cough were compared between the two groups at 6,12,24,48,and 72 h after surgery.The heart rate(HR)and mean arterial pressure(MAP)were measured before anesthesia(T0),at 5 min after administration(T1),during the nerve block procedure(T2),at the beginning of surgery(T3),at 30 min after surgery(T4),and immedi-ately after surgery(T5).The scores of the mini-mental state examination(MMSE)were measured before surgery,at 24 h and 72 h after surgery.The recovery status and adverse reactions to anesthesia were also compared between the two groups.Re-sults The VAS scores of the Esketamine group at rest and during cough at 6,12,24,48,and 72 h after surgery were lower than those of the control group(P＜0.05),and at T2-T4,the HR and MAP in the Esketamine group were lower than those in the control group(P＜0.05).The MMSE scores of the Esketamine group were higher than those of the control group at 24 and 72 h after surgery(P＜0.05),and the use of Sufentanil and Tramadol in the Esketamine group was less than that in the control group at 72 h after surgery(P＜0.05,P＜0.01).The duration of stay in anesthesia recovery room after surgery,the first time of food intake and off-bed activity in the Esketamine group were shorter than those in the control group(P＜0.01).There was no significant difference in the total incidence of adverse reactions related to anesthesia between the two groups(P＞0.05).Conclusion The application of general anesthesia combined with subanesthetic dose of Esketamine combined with ultrasound-assisted paraspinal block in thoracoscopic surgery can effectively ensure the stability of the patient's hemody-namics,alleviate postoperative pain,reduce postoperative cognitive impairment,reduce the use of other analgesics,and im-prove the quality of postoperative recovery,which is safe and reliable.
万方数据
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