转化医学杂志2025，Vol.14Issue(3)：161-164,4.DOI:10.3639/j.issn.2095-3097.2025.03.030
艾司氯胺酮自控静脉镇痛在胸腔镜手术患者术后镇痛中的应用价值
Application Value of Esketamine Patient-Controlled Intravenous Analgesia in Postoperative Analgesia of Patients with Thoracoscopic Surgery
摘要
Abstract
Objective To investigate the effects of esketamine combined with patient-controlled intravenous analgesia(PCIA)on postoperative pain and recovery in patients undergoing video-assisted thoracoscopic lobectomy(VATS).Methods A total of 74 patients who underwent VATS lobectomy between January 2023 and November 2024 were enrolled and randomly assigned via sealed-envelope method to either the esketamine group(n=37)or the control group(n=37).The esketamine group received PCIA with esketamine added to the regimen,while the control group received standard PCIA.Postoperative pain[as-sessed by the Numerical Rating Scale(NRS)],chronic post-surgical pain(CPSP),perioperative indicators,postoperative fatigue(ICFS-10),quality of recovery(QoR-15)and incidence rates of adverse events were compared between the two groups of patients..Results There was no statistical significance in the NRS score in the resting state NRS scores between groups after surgery(P>0.05).On the 2nd day after surgery,the esketamine group exhibited lower NRS scores during movement.(P<0.05),and lower CPSP scores compared to the control group(P<0.05).The esketamine group also required less sufentanil,fewer PCIA compres-sions,and had a shorter time to first ambulation(P<0.05).At different time points after surgery,the esketamine group showed lower ICFS-10 scores and higher QoR-15 scores than the control group(P<0.05).Additionally,the incidence of adverse events was significantly lower in the esketamine group(P<0.05).Conclusion Esketamine combined with PCIA effectively alleviates movement-associated pain after VATS,reduces the risk of CPSP,decreases opioid consumption,and enhances early recovery by improving postoperative fatigue and overall recovery quality,with a favorable safety profile.关键词
肺叶切除术/胸腔镜/静脉自控镇痛/艾司氯胺酮/术后镇痛效果Key words
Lobectomy/Thoracoscopic/Patient-controlled intravenous analgesia/Esketamine/Postoperative analgesic effect分类
医药卫生引用本文复制引用
刘彤,林威威,陈东文,陈本桢,高洪光,蒋蓉蓉,李军祥..艾司氯胺酮自控静脉镇痛在胸腔镜手术患者术后镇痛中的应用价值[J].转化医学杂志,2025,14(3):161-164,4.基金项目
四川省卫生健康委员会科研课题创新团队项目(24CXTD18) （24CXTD18）
"医学赋能及人才培养计划"临床科研项目(CRCF-YXFN-202201140) （CRCF-YXFN-202201140）
