不同剂量瑞芬太尼复合小剂量艾司氯胺酮用于腹腔镜妇科手术患者的效果及对麻醉效能、疼痛的影响
Effect of Different Doses of Remifentanil Combined with Low-dose Esketamine on Patients Undergoing Laparoscopic Gynecological Surgery and Its Effect on Anesthesia Efficacy and Pain
金成浩 1赵美一 1阴阅 1刘强 1李兴奎1
作者信息
- 1. 首都医科大学附属北京同仁医院麻醉科 北京 100005
- 折叠
摘要
目的:研究不同剂量瑞芬太尼复合小剂量艾司氯胺酮对腹腔镜妇科手术患者麻醉效果的影响.方法:选取2020年4月～2023年2月在本院接受腹腔镜妇科手术治疗的60例患者进行研究,根据瑞芬太尼静脉输注剂量将其分为小剂量组、中剂量组和大剂量组,每组各20例.三组均给予患者小剂量艾司氯胺酮(0.1 μg·kg),小剂量组给予患者0.1 μg/(Kg·min)瑞芬太尼,中剂量组给予患者0.3 μg/(Kg·min)瑞芬太尼,大剂量组给予患者0.5 μg/(Kg·min)瑞芬太尼.记录三组患者的麻醉起效时间、麻醉诱导时间、拔管时间和不良反应发生率,并检测其不同时间段的血流动力学和疼痛.结果:麻醉起效、麻醉诱导拔管时间比较,三组无显著差异(P＞0.05).平均动脉压(MAP)和心率(HR)比较,大剂量组和中剂量组T1、T2时间段均低于小剂量组,中剂量组T1、T2时间段低于大剂量组;三组T2时间段MAP、HR水平低于T0、T1时间段,T1时间段低于T0时间段(P＜0.05).疼痛视觉模拟量表(VAS)评分比较,大剂量组和中剂量组T1、T2时间段均低于小剂量组,中剂量组T1、T2时间段低于大剂量组;三组T2时间段MAP、HR水平低于T0、T1时间段,T1时间段低于T0时间段(P＜0.05).不良反应发生率比较,三组无显著差异(P＞0.05).结论:不同剂量瑞芬太尼复合小剂量艾司氯胺酮均能保障腹腔镜妇科手术的麻醉效果和安全性,但中剂量瑞芬太尼的应用更有利于稳定血流动力学,并减轻患者的疼痛程度.
Abstract
Objective:To study the effect of different doses of remifentanil combined with low-dose esketamine on anesthesia in patients undergoing laparoscopic gynecological surgery.Methods:A total of 60 patients who underwent laparoscopic gynecological surgery in our hospital from April 2020 to February 2023 were selected for study.According to the intravenous infusion dose of remifen-tanil,they were divided into low-dose group,medium-dose group and high-dose group,with 20 cases in each group.Patients in the three groups were given low-dose esketamine(0.1 μg·kg).Patients in the low-dose group were given 0.1 μg/(Kg·min)remifentanil,patients in the middle-dose group were given 0.3 μg/(Kg·min)remifentanil,and patients in the high-dose group were given 0.5 μg/(Kg·min)remifentanil.The duration of anesthesia onset,anesthesia induction,extubation,and incidence of adverse reactions were recorded in the three groups,and their hemodynamics and pain were examined for different time periods.Results:There was no significant difference in the onset time of anesthesia and the extubation time of anesthesia induction among the three groups(P＞0.05).Compared with the mean arterial pressure(MAP)and heart rate(HR),the high-dose group and the middle-dose group were lower than the low-dose group at T1 and T2,and the middle-dose group was lower than the high-dose group at T1 and T2;the levels of MAP and HR in the three groups at T2 were lower than those at T0 and T1,and those at T1 were lower than those at T(P＜0.05).Compared with the visual analogue scale(VAS)score,the T1 and T2 time periods of the high-dose group and the middle-dose group were lower than those of the low-dose group,and the T1 and T2 time periods of the middle-dose group were lower than those of the high-dose group;the levels of MAP and HR in the three groups at T2 were lower than those at T0 and T1,and those at T1 were lower than those at T0(P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion:Different doses of remifentanil combined with low-dose esketamine can ensure the anesthetic effect and safety of laparoscopic gynecological surgery,but the application of medi-um-dose remifentanil is more conducive to stabilizing hemodynamics and reducing the degree of pain in patients.
关键词
瑞芬太尼/不同剂量/小剂量艾司氯胺酮/腹腔镜妇科手术Key words
Remifentanil/Different doses/Low-dose esketamine/Laparoscopic gynecological surgery引用本文复制引用
出版年
2024
NETL
NSTL
万方数据