中国临床药学杂志2025，Vol.34Issue(8)：608-613,6.DOI:10.19577/j.1007-4406.2025.08.008
小剂量艾司氯胺酮复合舒芬太尼对腹腔镜手术患者术后抑郁及睡眠的影响
Effect of low-dose esketamine combined with sufentanil on depression and sleep quality in patients with laparoscopic gastrointestinal tumor resection
摘要
Abstract
AIM To investigate the effect of using small-dose esketamine combined with sufentanil for postoperative patient-controlled intravenous analgesia(PCIA)on depression and sleep quality in patients undergoing laparoscopic gastrointestinal tumor resection.METHODS A total of 80 patients who underwent laparoscopic gastrointestinal tumor resection in our hospital from January 2023 to August 2024 were randomly divided into 2 groups according to the random number table method,with 40 patients in each group.All patients received PCIA.The analgesic formulation of the control group consisted of sufentanil 2 μg·kg-1,dexmedetomidine 1μg·kg-1,and tropisetron 5 mg in 0.9％saline,for a total volume of 100 mL.The observation group received 1 mg·kg-1 esketamine on the basis of the control group.Scores of hospital anxiety and depression scale(HADS)and Pittsburgh sleep quality index(PSQI)scale on 1 day before surgery,1 day after surgery,3 days affter surgery and 5 days after surgery,the operation time,intraoperative blood loss,sufentanil dosage of intraoperative,postoperative anal exhaust time,sufentanil dosage of analgesia pump of 48 h postoperative,number of analgesia pump compressing and the number of relief analgesic cases were recorded.The visual analogue score(VAS),the difference in high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)at each time point after surgery,and the incidence of postoperative adverse reactions were also observed.RESULTS The HADS scores and PSQI in the observation group were lower than those in the control group on 1 day and 3 day after surgery(P＜0.05).There was no significant difference in operation time,intraoperative blood loss,intraoperative sufentanil consumption and the total incidence of postoperative adverse reaction between 2 groups(P＞0.05).In the observation group,the time for anal exhaust occurred earlier than in the control group,and the incidence of nausea and vomiting was lower in the observation group compared to the control group(P＜0.05).The VAS scores at 6,12,24,and 48 h after surgery in the observation group were lower than those in the control group(P＜0.05).The consumption of sufentanil at 48 h after surgery,the number of postoperative analgesic pump compressions and the number of remedial analgesia cases in the observation group were lower than those of control group(P＜0.05).Levels of the hs-CRP and IL-6 in the observation group were lower than those in the control group at 24 h after surgery(P＜0.05).CONCLUSION A small dose of esketamine combined with sufentanil for intravenous analgesia after laparoscopic gastrointestinal tumor resection could improve depression scores and sleep quality,reduce postoperative pain scores,and postoperative opioid consumption,promote the recovery of gastrointestinal function,and help alleviate the body's inflammatory response.关键词
艾司氯胺酮/患者自控静脉镇痛/胃肠道肿瘤/抑郁评分/睡眠质量Key words
esketamine/patient controlled intravenous analgesia/gastrointestinal tumor/depression score/sleep quality分类
医药卫生引用本文复制引用
邱靖,杜宇龙,姜小峰,庄波,彭文勇..小剂量艾司氯胺酮复合舒芬太尼对腹腔镜手术患者术后抑郁及睡眠的影响[J].中国临床药学杂志,2025,34(8):608-613,6.基金项目
浙江省医药卫生科技计划项目(编号2022KY1328) （编号2022KY1328）
金华市中心医院中青年科研项目(编号JY2023-7-01) （编号JY2023-7-01）
