Clinical research of esketamine combined with sufentanil for patient-controlled analgesia in patients after thoracoscopic surgery
Objective To investigate The effects of esketamine for patient-controlled intravenous analgesia(PCIA)in patients after thoracoscopic surgery.Methods One hundred and twenty patients who underwent thoracoscopic lobectomy surgery were selected.They were divided into a group S,group SK1,group SK2 and group SK3 using a random number table method,30 in each group.All patients received the same anesthesia induction and maintenance medication plan.PCIA was given after surgery.The group S was given sufentanil 2 μg/kg,the group SK1 was given esketamine 1 mg/kg+sufentanil 2 μg/kg,the group SK2 was given esketamine 1 mg/kg+sufentanil 1.5 μg/kg and the group SK3 was given esketamine 1 mg/kg+sufentanil 1 μg/kg.Related data such as NRS score and Ramsay score were recorded at 2 h(T1),4 h(T2),12 h(T3),24 h(T4)and 48 h(T5)after surgery.White blood cell count,neutrophil cell count and C-reaction protein(CRP)level were detected on the day before operation and after 2 days of operation.The first pressing time and the effective pressing numbers within 48 h,adverse reactions and degree of satisfaction were com-pared.Results At T3,the NRS score of group SK3 was significantly higher than group S.At T3 and T4,The NRS score of group SK3 was higher than group SK1 and group SK2.The NRS score of group SK1 was lower than group S.At T2 and T3,the Ramsay score of group SK1 was significantly higher than other groups.At T4,the Ramsay score of group SK1 was significantly higher than group SK3.The effective pressing numbers were increased and the first pressing time was advanced of group SK3.The white blood cell count,neu-trophil cell count and level of CRP had all increased after surgery.It was lower in group SK compared with group S.The incidence rate of postoperative adverse reactions of group SK2 and SK3 was significantly lower than group S and group SK1.Group SK2 had higher patient satisfaction than other three groups.Conclusions 1 mg/kg esketamine combined with 1.5 ug/kg sufentanil have satisfactory analgesic and sedative effect.This may reduce the inflammation stress and the incidence of adverse reactions.The method has high patient satisfaction.
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