川北医学院学报2025，Vol.40Issue(6)：708-712,5.DOI:10.3969/j.issn.1005-3697.2025.06.006
艾司氯胺酮联合竖脊肌平面阻滞对全麻下胸腔镜肺切除术患者术后恢复质量的影响
Effect of esketamine combined with erector spinae plane block on the qual-ity of recovery in patients after thoracoscopic lobectomy under general an-esthesia
摘要
Abstract
Objective:To investigate the effect of intravenous esketamine combined with erector spinae plane block(ESPB)on the postoperative recovery quality in patients undergoing thoracoscopic lobectomy with general anesthesia.Methods:A total of 97 pa-tients who underwent thoracoscopic lobectomy were divided into two groups:group K(n=49)and group C(n=48),according to whether or not they were given esketamine.Patients in K group were given slow intravenous injection of 0.2 mg/kg ketamine after anes-thesia induction and 5 minutes before surgical skin incision,and patients in group C received intravenous injection of physiological sa-line equivalent to group K drugs.Comparison of general indicators,quality of recovery at 24 h postoperatively[40-item Quality of Re-covery Rating Scale(QoR-40)score],cellular immune function before and after 24 h of treatment(NK cells,CD4+T cells,and CD8+T cells),hemodynamics at each time point,and the occurrence of postoperative adverse events between the two groups.Results:Intrao-perative remifentanil dosage was lower in group K than in group C(P＜0.05).The overall QoR-40 score,as well as the subscores for pain,emotional state,and physical comfort in group K were higher than those in group C at 24 hours postoperatively(P＜0.05).Addi-tionally,levels of NK cells,CD4+T cells,and CD8+T cells were higher in the group K than those in group C at 24 hours postoperative-ly(P＜0.05).There were no statistically significant differences in hemodynamics and total incidence of adverse effects between the two groups(P>0.05).Conclusion:The intravenous application of esketamine combined with ESPB for thoracoscopic lobectomy under general anesthesia reduces intraoperative remifentanil dosage,improves the quality of postoperative recovery and improves postoperative cellular immune function in patients without increasing adverse effects.关键词
艾司氯胺酮/竖脊肌平面阻滞/胸腔镜肺切除术/术后恢复质量Key words
Esketamine/Erector spinae plane block/Thoracoscopic lobectomy/Postoperative recovery quality分类
医药卫生引用本文复制引用
刘同馨,侯永超,何鹏,张正辉,周述芝..艾司氯胺酮联合竖脊肌平面阻滞对全麻下胸腔镜肺切除术患者术后恢复质量的影响[J].川北医学院学报,2025,40(6):708-712,5.基金项目
四川省科技厅重点科研项目(2023YFS0143) （2023YFS0143）
四川省雅安市科技局重点科技计划项目(22KJJH0004) （22KJJH0004）
