中国药物经济学2025，Vol.20Issue(2)：48-53,6.DOI:10.12010/j.issn.1673-5846.2025.02.009
艾司氯胺酮联合腹横肌平面阻滞对行腹腔镜袖状胃切除术患者的影响
Effect of Esketamine combined with Transverse Abdominal Muscle Plane Block on Patients undergoing Laparoscopic Sleeve Gastrectomy
摘要
Abstract
Objective To explore the effect of esketamine combined with transverse abdominal muscle plane block(TAPB)on patients undergoing laparoscopic sleeve gastrectomy.Methods A total of 120 patients who underwent laparoscopic sleeve gastrectomy in the First People's Hospital of Suqian City from April 2023 to April 2024 were selected as the study subjects,and were divided into control group,esketamine group,TAPB group and combination group according to random number table method,with 30 cases in each group.After anesthesia induction,patients in the control group were given intravenous injection of 0.5 mg/kg normal saline.Esketamine group was given 0.5 mg/kg esketamine intravenously,TAPB group was given TAPB;Patients in the combination group were treated with esketamine combined with TAPB.Pain visual analogue scale(VAS)was used to evaluate the analgesic effect at different time points.The plasma levels of epinephrine and norepinephrine were determined by enzyme-linked immunosorbent assay(ELISA),and the levels of cortisol were analyzed by radioimmunoassay.Recovery quality score(QoR-15)was selected to evaluate the quality of recovery after 24 hours of anesthesia.Recording the first exhaust time and first defecation time;Postoperative adverse reactions were observed.Results Compared with the control group,VAS scores,levels of postoperative plasma epinephrine,norepinephrine and cortisol,first exhaust time and first defecation time were decreased in esketamine group at different time points(P＜0.05),and pain scores in QoR 15 24 h after surgery were increased(P＜0.05).Compared with Esketamine group and TAPB group,the results showed that:VAS scores at different time points in combination group,the levels of plasma epinephrine,norepinephrine and cortisol,first exhaust time and first defecation time were decreased(P＜0.05),and pain scores in QoR-15 24 h after surgery were increased(P＜0.05).The incidence of postoperative adverse reactions in control group,esketamine group,TAPB group and combined group were 23.34%,13.32%,13.32%and 3.33%,respectively.There was no significant difference among control group,esketamine group and TAPB group(P＞0.05).The incidence of adverse reactions in combination group was decreased(P＜0.05).Conclusion Esketamine combined with TAPB can alleviate postoperative pain in patients with laparoscopic sleeve gastrectomy,improve stress response,and promote the recovery of gastrointestinal function,with fewer adverse reactions and high safety.关键词
腹腔镜袖状胃切除术/艾司氯胺酮/腹横肌平面阻滞/镇痛/胃肠功能/应激反应Key words
Laparoscopic sleeve gastrectomy/Esketamine/Abdominal transverse muscle plane block/Analgesia/Gastrointestinal function/Stress response分类
临床医学引用本文复制引用
申帅,倪小磊,余小燕..艾司氯胺酮联合腹横肌平面阻滞对行腹腔镜袖状胃切除术患者的影响[J].中国药物经济学,2025,20(2):48-53,6.基金项目
江苏省妇幼健康科研项目(F201753) （F201753）
