机器人外科学杂志（中英文）2025，Vol.6Issue(1)：53-59,7.DOI:10.12180/j.issn.2096-7721.2025.01.010
亚麻醉剂量艾司氯胺酮联合肋缘下腹横肌平面阻滞在机器人辅助根治性膀胱切除术患者中的应用效果
Effect of subanesthetic dose of esketamine combined with subcostal transversus abdominis plane block in patients undergoing robot-assisted radical cystectomy
摘要
Abstract
Objective:To investigate the effects of subanesthetic dose of esketamine combined with subcostal transversus abdominis plane block(STAPB)on the analgesic effect,stress response,awakening quality,and mood of patients undergoing robot-assisted radical cystectomy(RARC).Methods:70 patients who underwent RARC in Baoji People's Hospital from August 2023 to February 2024 were selected and divided into the control group(conventional anesthesia combined with STAPB,n=35)and the study group(subanesthetic dose of esketamine combined with STAPB,n=35)using a random number table,and the clinical indicators of the two groups were compared.Results:The postoperative pain numerical rating scale(NRS)scores showed a decreasing trend over time in both groups,and the scores of the study group were lower than those of the control group(P<0.05).At the preoperative period(T0),10 minutes after the start of the operation(T1),and 5 minutes after extubation(T2),the diastolic blood pressure(DBP)decreased and then increased in both groups.At T1 and T2,the DBP in the study group was higher than that in the control group.Systolic blood pressure(SBP)in the study group initially decreased and then increased,whereas in the control group it initially increased and then decreased.At T1 and T2,the study group showed lower SBP than that of the control group.In both groups,the heart rate(HR)initially increased and subsequently decreased,it was lower in the study group than the the control group at T1 and T2(P<0.05).The awakening-related time was shorter in the study group,and at 15 and 30 minutes after extubation,the study group got higher Steward's Awakening Scale scores than the control group(P<0.05).At 3 d after surgery,both groups had lower scores on the self-rating depression scale(SDS)and self-rating anxiety scale(SAS)and increased levels of various inflammatory factors,while it was lower in the study group than that in the control group(P<0.05).There is no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion:The use of subanesthetic dose of esketamine combined with STAPB can reduce the stress response and inflammatory response,alleviate the anxiety and depression,and obtain a higher quality of awakening in RARC patients,with a certain degree of safety and an effective clinical application.关键词
艾司氯胺酮/肋缘下腹横肌平面阻滞/机器人辅助根治性膀胱切除术/镇痛效果/应激反应/苏醒质量Key words
Esketamine/Subcostal Transverse Abodominis Plane Block/Robot-assisted Radical Cystectomy/Analgesic Effect/Stress Response/Quality of Awakening分类
医药卫生引用本文复制引用
闫岸军,陈治富,马亚芳..亚麻醉剂量艾司氯胺酮联合肋缘下腹横肌平面阻滞在机器人辅助根治性膀胱切除术患者中的应用效果[J].机器人外科学杂志（中英文）,2025,6(1):53-59,7.基金项目
陕西省重点研发计划项目(2021SF-265) Key R&D Plan Project of Shaanxi Province(2021SF-265) （2021SF-265）
