Comparison of the Efficacy of Different Doses of Esketamine Combined with Dexmedetomidine in Patients with Postoperative Patient-controlled Intravenous Analgesia for Esophageal Cancer
Objective To analyze the efficacy of different doses of Esketamine combined with dexmedetomidine in pa-tient controlled intravenous analgesia(PCIA)after esophageal cancer surgery.Methods 87 patients with esophageal cancer were selected and randomly divided into the control group,and the observation group using a random number table method,with 29 ca-ses in each group.All patients underwent esophageal cancer radical surgery,and PCIA was used postoperatively.The formula of the conventional group analgesic solution was 100 μ G dexmedetomidine+2 μ G/kg sufentanil+0.25 mg palonol+100 ml sodi-um chloride injection.The control group received 0.03 mg/(kg·h)ketamine in addition to the conventional group,while the ob-servation group received 0.015 mg/(kg·h)ketamine in addition to the conventional group.Compared the analgesic effects,lev-els of inflammatory factors,stress reactions,depressive symptoms,and adverse reactions among three groups.Results At 12h,and 24h after surgery,the VAS score of the control group was significantly lower than that of the observation group and the convention-al group(P＜0.05);Before surgery,there was no statistically significant difference in C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT),norepinephrine(NE),and cortisol(Cor)among the three groups(P＞0.05);24 hours after surgery and at the end of the surgery,the CRP,IL-6,PCT,NE,and Cor in the control group were lower than those in the observation group and the control group,and the difference was statistically significant(P＜0.05).Before surgery,there was no statistically significant difference in SDS scores among the three groups(P＞0.05);One week after surgery,SDS score of the observation group was sig-nificantly lower than that of the control group and the conventional group(P＜0.05);The adverse reactions in the 3 groups were similar,with no statistically significant difference(P＞0.05).Conclusion High dose of Esketamine combined with dexmedeto-midine can achieve a stronger analgesic effect in PCIA after esophageal cancer surgery,and can more effectively control the in-flammatory and stress reactions of the body.However,low dose of Esketamine has fewer adverse reactions and stronger antidepre-ssant effects.
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