机器人外科学杂志（中英文）2025，Vol.6Issue(2)：245-250,6.DOI:10.12180/j.issn.2096-7721.2025.02.010
不同剂量右美托咪定联合盐酸艾司氯胺酮对机器人辅助腹腔镜下根治性前列腺切除术患者的影响
Effect of different doses of dexmedetomidine combined with esketamine hydrochloride in patients undergoing robot-assisted laparoscopic radical prostatectomy
摘要
Abstract
Objective:To investigate the effect of different doses of dexmedetomidine combined with esketamine hydrochloride in patients undergoing robot-assisted laparoscopic radical prostatectomy(RARP)and its influence on hemodynamics,cognitive function,delirium,and the incidence of adverse reactions.Methods:80 patients who underwent RARP from January 2021 to January 2024 in Drum Tower Hospital Affiliated to Nanjing University Medical School were prospectively selected and divided into three groups:25 patients in the group A and group B,30 patients in group C.Group A was given 0.2 mg/kg esketamine hydrochloride+physiological saline,group B was given 0.2 mg/kg esketamine hydrochloride+0.5 μg/(kg·h)dexmedetomidine,and group C was given 0.2 mg/kg esketamine hydrochloride+0.7 μg/(kg·h)dexmedetomidine.Hemodynamic indexes,Ramesay sedation score,visual analog scale(VAS)score,quality of awakening,Montreal cognitive assessment(MoCA)score,delirium,and incidence of adverse reactions were compared among the three groups.Results:At the moment of endotracheal intubation and the beginning of surgery,the oxygen saturation decreased in the three groups of patients,and it was higher in group B and group C than group A(P＜0.05).Heart rate and mean arterial pressure increased in the three groups of patients,and they were lower in group B and group C than group A(P＜0.05).The comparison of hemodynamic indexes of patients between group B and group C at each point in time showed no statistically significant difference(P＞0.05).The differences in Ramesay sedation scores at postoperative wakefulness,2 h and 6 h after surgery among the three groups of patients were not statistically significant(P＞0.05).VAS scores at 2 h and 6 h after surgery in group B and group C were lower than group A(P＜0.05),and the differences between group B and group C were not statistically significant(P＞0.05).The time for removing tracheal intubation and calling for the time of self-opening of eyes were shorter in group B than those in group A and group C(P＜0.05),the recovery time of spontaneous respiration in group B and C was shorter than that in group A,and the intraoperative dosages of propofol and sufentanil were less than those in group A(P＜0.05).The MoCA scores at 1 d after surgery in group B and C were higher than those in group A(P＜0.05),and the difference between group B and C was not statistically significant(P＞0.05).The incidence of delirium in group B and C was lower than that in group A(P＜0.05),and the total incidence of adverse reactions in group B was lower than that in group A and C(P＜0.05).Conclusion:Dexmedetomidine combined with esketamine hydrochloride in patients with RARP can effectively reduce the fluctuation of postoperative hemodynamic indexes of patients,enhance the postoperative analgesic effect and the quality of awakening,lower the dosage of intraoperative propofol and sufentanil,improve the level of postoperative cognitive function,and decrease the incidence of delirium,and applying a dose of dexmedetomidine at the dose of 0.5μg/(kg·h)was more effective.关键词
右美托咪定/盐酸艾司氯胺酮/机器人辅助手术/根治性前列腺切除术Key words
Dexmedetomidine/Esketamine Hydrochloride/Robot-assisted Surgery/Radical Prostatectomy分类
临床医学引用本文复制引用
宿明艳,刘晓杰,崔士和,周瑜..不同剂量右美托咪定联合盐酸艾司氯胺酮对机器人辅助腹腔镜下根治性前列腺切除术患者的影响[J].机器人外科学杂志（中英文）,2025,6(2):245-250,6.基金项目
国家自然科学基金青年科学基金项目(H0903) National Natural Science Foundation of China(H0903) （H0903）
