中国临床药理学杂志2025，Vol.41Issue(14)：1969-1973,5.DOI:10.13699/j.cnki.1001-6821.2025.14.004
艾司氯胺酮在胸腔镜肺叶切除术患者中的临床研究
Clinical trial of esketamine in patients undergoing thoracoscopic lobectomy
摘要
Abstract
Objective To explore clinical curative effect and safety of different doses of esketamine injection in patients undergoing thoracoscopic lobectomy(TL).Methods Patients undergoing TL were enrolled as the research objects.According to random number table method,they were divided into group A(0.25 mL·kg-1 esketamine anesthesia),group B(0.5 mL·kg-1)and group C(normal saline).The remifentanil dosage,propofol dosage,postoperative awaking time,visual analogue scale(V AS),heart rate(HR),mean arterial pressure(MAP),mini-mental state examination(MMSE)and adverse drug reactions were compared among the three groups.Results A total of 110 patients were screened,96 patients were enrolled,including 32 patients in each group.The dosage of remifentanil in group A,group B and group C were(806.37±132.36),(724.21±122.09)and(889.22±144.10)μg,respectively;the dosage of propofol were(401.43±88.26),(380.79±70.79)and(468.72±89.54)mg,respectively;the postoperative recovery time was(10.85±2.32),(15.63±2.73)and(18.66±3.09)min,respectively.The dosage of remifentanil and propofol in group A and group B were significantly lower than those in group C,and the postoperative recovery time was significantly shorter than that in group C(all P＜0.05).At 1,6,12 and 24 hours after operation,the VAS scores of group A and group B were lower than those of group C(P＜0.05).There were no statistically significant differences in HR and MAP levels among the three groups(all P＞0.05).At 1 and 2 days after operation,the MMSE scores of group A were(23.99±0.82)and(25.77±0.97)scores,respectively;group B were(23.55±0.89)and(25.31±1.02)scores,respectively;group C were(22.81±0.84)and(24.56±0.96)scores,respectively.The scores of group A and group B were statistically significantly higher than those of group C,and the scores of group A were statistically significantly higher than those of group B(all P＜0.05).The total incidence of adverse drug reactions in group A(12.50％)was lower than that in group B(37.50％)and group C(40.62％)(all P＜0.05).Conclusion 0.25 mL·kg-1 esketamine for anesthesia induction is beneficial to accelerate postoperative awaking,relieve postoperative pain and improve postoperative cognitive function in TL patients,with high safety.关键词
艾司氯胺酮注射液/胸腔镜肺叶切除术/麻醉/镇痛效果/苏醒时间Key words
esketamine injection/thoracoscopic lobectomy/anesthesia/analgesia effect/recovery time分类
医药卫生引用本文复制引用
廖永锋,王辉,张跃东..艾司氯胺酮在胸腔镜肺叶切除术患者中的临床研究[J].中国临床药理学杂志,2025,41(14):1969-1973,5.基金项目
皖南医学院教学医院科研专项基金资助项目(JXYY202114) （JXYY202114）
