摘要
Abstract
Objective To explore the application effect and stress response of ketamine combined with double lumen endotracheal intubation general anesthesia for thoracoscopic lobectomy.Methods A total of 90 patients who underwent thoracoscopic lobectomy in the First People's Hospital of Longnan City from June 2021 to June 2024 were selected and divided into routine general anesthesia group and esketamine group by random number table method,45 cases in each group.All patients were given general anesthesia with double lumen bronchial cannula.The esketamine group was injected with 0.1 mg/kg esketamine before induction and pumped with 0.12 mg/kg·h esketamine during operation.The conventional general anesthesia group was injected with 0.9%sodium chloride injection before induction and during operation.The rate of good and good anesthesia was compared between the two groups,and the stress response indexes(cortisol(COR),norepinephrine(NE),epinephrine(E))were changed at the time of entry(T1),2 min after anesthesia(T2),immediately after the operation(T3),30 min after surgery(T4),and immediately after surgery(T5),the postoperative visual analogue scale(VAS)score,incidence of adverse reactions and agitation during recovery were compared.Results The excellent and good rate of anesthesia in esketamine group was 100.00%higher than that in general anesthesia group 88.89%(P＜0.05).COR,NE and E at T3,T4 and T5 in Esketamine group were lower than those in conventional general anesthesia group(P＜0.05).The VAS scores of esketamine group at 2 h,24 h,48 h and 72 h after extubation were lower than those of conventional general anesthesia group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).The incidence of agitation during recovery in Esketamine group was 2.22%lower than that in conventional general anesthesia group(15.56%)(P＜0.05).Conclusion The use of ketamine combined with double lumen bronchial intubation general anesthesia for patients undergoing thoracoscopic lobectomy can improve the anesthesia quality rate,reduce intraoperative stress response and postoperative pain,and has higher safety compared to pure double lumen bronchial intubation general anesthesia.At the same time,it can also reduce the incidence of agitation in patients during the recovery period.关键词
艾司氯胺酮/双腔支气管插管全身麻醉/胸腔镜肺叶切除术/应激反应/不良反应/麻醉效果Key words
Ketamine/Double lumen bronchial intubation general anesthesia/Thoracoscopic lobectomy/Stress response/Adverse reactions/Anesthesia effect分类
医药卫生
