首页|术中静脉注射不同剂量的艾司氯胺酮对乳腺癌患者术后焦虑、抑郁的影响

术中静脉注射不同剂量的艾司氯胺酮对乳腺癌患者术后焦虑、抑郁的影响

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目的 探讨术中静脉注射不同剂量的艾司氯胺酮对乳腺癌患者术后焦虑、抑郁的影响.方法 选择择期行乳腺癌改良根治术患者96例,采用随机数字表法将患者分为艾司氯胺酮L组(0.15mg/kg)、M组(0.30mg/kg)、H组(0.50mg/kg)和生理盐水组(C组),每组各24例,在麻醉诱导时给予.记录术前1天(D1)、术后1天(D2)、术后3天(D3)、术后5天(D4)、术后7天(D5)的状态焦虑量表(state anxiety scale,SAI)评分、蒙哥马利抑郁量表(montgomery depression scale,MADRS)评分;记录术中瑞芬太尼用量、去氧肾上腺素用量、手术时长等数据.记录从麻醉结束至拔管时间,记录术后PACU停留时间、术后24h内谵妄、恶心呕吐(postoperative nausea and vomiting,PONV)、头晕、嗜睡、镇痛补救率.结果 D3时,H组较其他3组有更低的SAI评分(P<0.05);与D1时比较,C组、L组、M组的D4、D5时SAI评分明显下降(P<0.05);H组D3、D4、D5时SAI评分下降(P<0.05);D3、D4时H组MADRS评分较另外3组降低(P<0.05);与D1时比较各组的MADRS评分随着时间的延长逐渐下降(P<0.05);H组瑞芬太尼消耗量较其他3组降低(P<0.05);4组患者术后谵妄、PONA、补救镇痛、头晕嗜睡、发热等不良反应发生率差异无统计学意义(P>0.05);结论 术中静脉注射艾司氯胺酮可以降低乳腺癌患者术后3天的SAI及MADRS评分,减少术中阿片类药物的用量,且不增加术后不良反应的发生率.
Effects of Different Doses of Esketamine on Postoperative Anxiety and Depression in Patients with Breast Cancer
Objective To investigate the effect of different doses of esketamine on postoperative anxiety and depression in patients with breast cancer.Methods A total of 96 patients undergoing modified radical mastectomy were randomly divided into esketamine L group(0.15mg/kg),M group(0.30mg/kg),high-dose H group(0.50mg/kg),and normal saline group(C group)with 24 cases in each group which will be given during induction of anesthesia.State Anxiety Scale(SAI)score and Montgomery Depression Scale(MADRS)score were recorded 1day before surgery(D1),1day after surgery(D2),3days after surgery(D3),5days after surgery(D4),and 7days after surgery(D5).Data such as the dosage of remifentanil,the dosage of norepinephrine,and the duration of the op-eration(from the beginning of the operation to the end of the operation)were recorded during the operation.The time from the end of an-esthesia to extubation and the postoperative PACU residence time was recorded,and delirium,postoperative nausea and vomiting(PONV),dizziness,drowsiness,and pain relief rate within 24hours after surgery were recorded.Results At D3,group H had a lower SAI score than the other three groups(P<0.05);compared with D1,the SAI score at D4 and D5 in groups C,L,and M was signifi-cantly decreased(P<0.05).The SAI score of group H at D3,D4,and D5 was decreased(P<0.05);the MADRS score of group H was lower than that of the other three groups at D3 and D4(P<0.05);compared with D1,the MADRS score of all groups gradually de-creased with the extension of time(P<0.05).Remifentanil consumption in group H was significantly lower than that in the other three groups(P<0.05).There were no significant differences in the incidence of postoperative delirium,PONA,remedial analgesia,dizzi-ness,lethargy,and fever among the four groups(P>0.05).Conclusion Intraoperative intravenous injection of esketamine can reduce the SAI and MADRS scores,reduce the perioperative opioid consumption,and not increase the incidence of postoperative adverse reac-tions in breast cancer patients.

Breast cancerEsketamineAnxietyDepression

季涛、刘苏、苏高伟、吴南玲、王瑶琳、陈秀侠

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221002 徐州医科大学附属医院麻醉科

乳腺癌 艾司氯胺酮 焦虑 抑郁

江苏省高等学校自然科学研究重大项目

22KJA320007

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(1)
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