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艾司氯胺酮与术后认知功能障碍的研究现状

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艾司氯胺酮作为一种新型的N-甲基-D-天冬氨酸(NMDA)受体拮抗药,药理作用机制和位点与氯胺酮基本一致,但其对NMDA受体的亲和力是氯胺酮的3~4倍,镇痛效果是氯胺酮的2-2.5倍,且具有较少的精神药物不良反应.术后认知功能障碍是接受麻醉和手术的老年人最常见的并发症,在大于65岁的老年患者发生率较高,严重影响患者的术后恢复质量,同时增加医疗负担,是临床亟待解决的难题之一.近年来,随着艾司氯胺酮的临床应用,发现术中使用艾司氯胺酮可使手术患者血流动力学更平稳,减少炎性因子的释放,降低术后认知功能障碍的发生率.本文就国内外艾司氯胺酮在临床及基础研究领域对术后认知功能障碍影响的研究现状进行综述,以期为临床提供参考.
Research status of esketamine and postoperative cognitive dysfunction
Objective As a new type of N-methyl-D-aspartic acid(NMDA)receptor antagonist,esmolamine has the same pharmacological mechanism and site as ketamine,but its affinity to NMDA receptor is 3-4 times that of ketamine,and its analgesic effect is 2-2.5 times that of ketamine.Postoperative cognitive dysfunction is the most common complication in elderly patients undergoing anesthesia and surgery.The incidence is higher in elderly patients over 65 years old,which seriously affects the quality of postoperative recovery and increases the medical burden.It is one of the clinical problems to be solved urgently.In recent years,with the clinical application of esmolamine,it has been found that intraoperative use of esmolamine can make the hemodynamics of surgical patients more stable,reduce the release of inflammatory factors and reduce the incidence of postoperative cognitive impairment.This article reviews the research progress of the effect of esmolamine on postoperative cognitive dysfunction in the field of clinical and basic research at home and abroad,in order to provide clinical reference.

esmolaminepostoperative cognitive impairmentperioperative neurocognitive impairment

高世龙、韩学成、马文虎、王学军

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青海红十字医院麻醉科,青海西宁 810000

艾司氯胺酮 术后认知功能障碍 围术期神经认知障碍

国家自然科学基金面上项目青海省自然科学基金

816601972019-ZJ-930

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(16)