目的 探究艾司氯胺酮联合舒芬太尼应用于脊柱手术对其围术期指标及术后镇痛、镇静效果的影响。方法 回顾性分析2021年10月至2023年10月浙江省丽水市人民医院收治的脊柱手术术后患者120例，根据治疗方法的不同分为观察组(58例)和对照组(62例)。对照组患者使用舒芬太尼进行镇痛治疗，观察组在对照组基础上联合艾司氯胺酮进行干预。记录2组研究对象的术中失血量、补液量、手术时间、术后不同时间点(4 h、8 h、12 h、24 h、48 h)的视觉模拟疼痛评分(VAS);术后Ramsay镇静评分以及接受干预后不良反应发生率，并进行比较。结果 2组研究对象的术中失血量、补液量、手术时间差异无统计学意义(t=0。274，0。450，0。574，0。332;P=0。785，0。653，0。567，0。741);观察组术后 4 h、8 h、12 h、24 h 的 VAS 评分低于对照组(t=6。952，5。313，3。467，3。449;P＜0。01);2 组研究对象的术后 4 h、8 h、12 h、24 h、48 h Ramsay 镇静评分差异无统计学意义(t=0。657，0。438，1。748，0。805，0。737;P=0。512，0。662，0。083，0。424，0。462);2 组研究对象的不良反应发生率差异无统计学意义(x2=1。136，P=0。287)。结论 艾司氯胺酮联合舒芬太尼能够有效缓解术后疼痛、改善镇静效果，具有良好的应用价值。
Effects of esketamine combined with sufentanil on perioperative indexes and postoperative analgesia and sedation in spinal surgery
Objective To explore the effect of esketamine combined with sufentanil on perioperative in-dexes and postoperative analgesia and sedation in spinal surgery.Methods A total of 120 patients undergoing spinal surgery in Lishui People's Hospital were retrospectively analyzed from October 2021 to October 2023.Ac-cording to different treatment methods,they were divided into observation group(n=58)and control group(n=62).The control group was treated with sufentanil for analgesia,while observation group was additionally treated with esketamine.The intraoperative blood loss,fluid replacement volume,operation time,scores of visual analogue scale(VAS)at different time points after surgery(4 h,8 h,12 h,24 h,48 h),scores of postoperative Ramsay sedation and incidence of adverse reactions after intervention in the two groups were recorded and compared.Results There was no significant difference in intraoperative blood loss,fluid replacement volume or operation time be-tween the two groups(t=0.274,0.450,0.574,0.332;P=0.785,0.653,0.567,0.741).At 4 h,8 h,12 h and 24 h after surgery,VAS scores in observation group were significantly lower than those in control group(t=6.952,5.313,3.467,3.449;P=0.001).There was no significant difference in scores of postoperative Ramsay sedation between the two groups(t=0.657,0.438,1.748,0.805,0.737;P=0.512,0.662,0.083,0.424,0.462).The incidence of adverse re-actions after intervention showed that there was no significant difference in the incidence of adverse reactions be-tween the two groups(x2=1.136,P=0.287).Conclusion Esketamine combined with sufentanil can effectively re-lieve postoperative pain and improve sedative effect,which has good application value.
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