单次亚麻醉剂量氯胺酮对全麻下结直肠癌根治术患者术后早期情绪反应及恢复情况的影响

The Influence of Chloramine Ketone in Single Sub-anesthetic Dose on Postoperative Early Mental Stress and Its Recovery Status of the Colorectal Cancer Patients Underwent Radical Surgery Under General Anesthesia

目的:探讨术前单次亚麻醉剂量氯胺酮给药对全麻下结直肠癌根治术患者术后早期情绪反应及恢复情况的影响。方法:将2017年1月至2019年1月拟于全麻下行结直肠癌根治术治疗的66例患者纳入本研究,随机分为观察组和对照组,各33例。除观察组全麻诱导后(手术切皮前5min)一次性静脉推注亚麻醉剂量氯胺酮(0.3mg/kg),对照组一次性静脉推注等体积的0.9%氯化钠注射液外,2组全麻诱导、术中麻醉维持及术后静脉自控镇痛用药及方式均相同。比较2组患者术前、术后48h焦虑和抑郁情况,拔管时间,拔管后30min不良反应,术后48h疼痛程度及整体恢复质量等。焦虑抑郁情况采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评价,疼痛程度评价采用VAS评分法,术后48h恢复质量采用40项恢复质量评分量表(QOR40)评价。结果:术后48h,观察组SAS、SDS评分均明显低于对照组,QOR40评分明显高于对照组,VAS评分明显低于对照组,P<0.05。2组患者术后拔管时间比较差异无统计学意义,P>0.05;且2组拔管后30min内均未发生谵妄、躁动、恶心、呕吐、头晕等不良反应。结论:全麻下结直肠癌根治术者术前单次亚麻醉剂量氯胺酮给药,可减轻患者术后早期焦虑、抑郁程度,降低术后疼痛程度,提高术后恢复质量。

Objective To explore the influence of chloramine ketone(CAK)in single sub-anesthetic dose on postoperative mental early stress and its recovery status of colorectal cancer patients underwent radical surgery under general anesthesia.Methods Enrolled 66patients to be subject to above-mentioned surgery(2017-01-2019-01),and randomly divided them into observation group[33cases,after induction of general anesthesia(5min before skin-incised)once only intravenously do bolus of sub-anesthesia dose of CAK(0.3mg/kg)]and control group(33cases,instead of 0.9%NaCl injection in the same volume of CAK);both groups’general anesthesia induction,intraoperative anesthesia maintenance,as well as the dosage and its patterns in postoperative patient-controlled intravenous analygesia(PCIA)were same;compared anxiety(by SAS evaluation)and depression(by SDS evaluation)status before surgery and 48hrs after surgery,extubation time,unward reaction 30min after extubation,the pain intensity(by VAS method evaluation),as well as patients’whole recovery quality(by QOR40evaluation)between the two groups.Results In the ratings on SAS and SDS 48hrs after surgery,in QOR40ratings,and in VAS ratings observation group were respectively and significantly lower,higher,and lower than control group(P<0.05,all);in extubation time there was no statistical difference between the two groups(P>0.05),and within 30min after extubation no unward reactions such as delirium,agitation,nausea,vomiting,and dizziness,etc.were found in both groups.Conclusion Preoperatively injecting CAK in single sub-anesthetic dose for the patients with colorectal cancer undergoing radical surgery under general anesthesia can relieve their early postoperative anxiety and depression degree,reduce postoperative pain intensity,and enhance postoperative recovery quality.