艾司氯胺酮诱导预防烧伤患者术后寒战的研究

Esketamine induction for prevention of perioperative shivering in burn patients

目的观察艾司氯胺酮诱导预防烧伤患者术后寒战的效果。方法选择2021年5月至2022年6月浙江中医药大学附属嘉兴中医医院行烧伤削痂手术患者57例。采用随机数字表法分为研究组29例和对照组28例。研究组给予艾司氯胺酮0.5 mg/kg麻醉诱导,对照组给予芬太尼4μg/kg麻醉诱导。记录并比较两组患者诱导前、诱导后5 min、拔管后5 min的心率(HR)、平均动脉压(MAP)以及诱导前、拔管后5 min的体温,计算体温差;观察两组患者术后寒战严重程度以及不良反应发生情况。结果研究组诱导后5 min的MAP、HR及拔管后5 min的MAP均高于对照组,拔管后5 min的体温与诱导前的体温差小于对照组,差异均有统计学意义(均P<0.05)。研究组术后寒战发生率为24.14%(7/29),低于对照组的53.57%(15/28),差异有统计学意义(P<0.05)。研究组术后发生恶心、呕吐1例,对照组为7例,两组患者恶心、呕吐比较差异有统计学意义(P<0.05)。结论艾司氯胺酮诱导可有效减少烧伤患者术后寒战的发生,且降低术后不良反应发生率。

Objective To investigate the effect of esketamine induction on postoperative shivering in burn patients.Methods Fifty-seven patients undergoing burn surgery in Jiaxing Hosptial of Traditional Chinese Medicine from May 2021 to June 2022 were randomly divided into two groups,patients in study group(n=29)received esketamine(0.5 mg/kg)induction and patients in control group(n=28)received fentanyl(4μg/kg)induction.The HR,MAP before induction,5 min after induction and 5 min after extubation;body temperature difference between 5 min after extubation and before induction(ΔT);the severity of postoperative shivering(PAS)and adverse effects were recorded.Results The hemodynamics of the study group was smoother than that of the control group at 5 min after induction(P<0.05);theΔT in the study group was smaller than that in the control group(P<0.05);the severity of postoperative shivering in the study group was smaller than that in the control group(P<0.05).Conclusion Esketamine induction can effectively reduce the occurrence of postoperative shivering reaction in burn patients without increasing the occurrence of postoperative adverse reactions.