摘要
Abstract
Objective:To investigate the application value of esketamine combined with propofol in the induction of general anesthesia in elderly patients undergoing laparoscopic cholecystectomy.Methods:A total of 90 elderly patients undergoing laparoscopic cholecystectomy during January 2022 to January 2024 in a hospital were selected and divided into the control group and the observation group by envelope method and single-blinded method,with 45 patients in each group.The control group was given sufentanil citrate injection combined with propofol injectable emulsion for anesthesia,and the observation group was given esketamine hydrochloride injection combined with propofol injectable emulsion for anesthesia.The clinical indexes(recovery time of spontaneous respiration,eye opening time,extubation time),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),blood oxygen saturation(SpO2)at different time points[before anesthesia(T0),at intubation(T1),at the end of surgery(T2)and 5 minutes after surgery(T3)],mini-mental state examination(MMSE)score,visual analogue scale(VAS),stress indexes[cortisol(Cor)and epinephrine(E)]and adverse reactions were compared between the two groups.Results:The recovery time of spontaneous respiration,eye opening time and extubation time in the observation group were earlier than those in the control group(P<0.05).HR,DBP and SBP at T1,T2 and T3 in both groups were higher than those at T0(P<0.05),while lower in the observation group than in the control group(P<0.05).There was no statistically significant difference in SpO2 between the two groups at different time points(P>0.05).There was no statistically significant difference in MMSE score between the two groups before treatment and 6 hours after operation(P>0.05).There was no statistically significant difference in pain VAS score between the two groups at 1 h,6 h and 12 h after operation(P>0.05).At 6 h after operation,the serum levels of Cor and E were increased in both groups(P<0.05),while lower in the observation group than in the control group(P<0.05).The total incidence of adverse reactions in the observation group(6.67%)was lower than that in the control group(24.44%,P<0.05).Conclusion:Esketamine combined with propofol has a good application value in the induction of general anesthesia in elderly patients laparoscopic cholecystectomy,which is helpful to stabilize hemodynamics,reduce stress response,shorten the recovery time of patients,and reduce the incidence of adverse reactions.关键词
艾司氯胺酮/丙泊酚/老年患者/腹腔镜胆囊手术/全麻Key words
esketamine/propofol/elderly patients/laparoscopic cholecystectomy/general anesthesia分类
医药卫生
