小剂量艾司氯胺酮在腹腔镜手术全身麻醉中的镇痛效果分析

Analysis of Analgesic Effect of Low-dose Esketamine in General Anesthesia for Laparoscopic Surgery

目的研究小剂量艾司氯胺酮用于腹腔镜手术全身麻醉的镇痛效果及副反应。方法选取2020年7月-2021年12月萍乡市湘东区人民医院行腹腔镜全麻手术的80例患者为研究对象,经随机数字表法分为对照组(40例)与观察组(40例)。对照组行常规全麻用药,观察组在其基础上应用小剂量艾司氯胺酮,比较两组麻醉苏醒时间(自主呼吸恢复时间、定向力恢复时间、拔管时间)、苏醒质量[Ricker镇静-躁动评分(SAS)、改良Aldrete评分]、术后镇痛效果[疼痛视觉模拟评分(VAS)]及药物副反应。结果观察组自主呼吸恢复时间、定向力恢复时间、拔管时间短于对照组(P<0.05);观察组苏醒期SAS评分低于对照组,改良Aldrete评分高于对照组(P<0.05);观察组术后2、6、12 h的VAS评分均低于对照组(P<0.05);观察组药物副反应发生率小于对照组(P<0.05)。结论小剂量艾司氯胺酮在腹腔镜手术全麻方案中具有确切的镇痛效果,可缩短患者麻醉苏醒时间,改善其苏醒质量,缓解术后疼痛,且药物副反应少。

Objective To study the analgesic effect and side effects of low-dose esketamine for general anesthesia in laparoscopic surgery.Methods From July 2020 to December 2021,80 patients who underwent laparoscopic general anesthesia in Xiangdong District People's Hospital of Pingxiang were selected as the research objects.They were divided into control group(40 patients)and observation group(40 patients)by random number table method.The control group was treated with routine general anesthesia,and the observation group was treated with low-dose esketamine on the basis of the control group.The anesthesia recovery time(spontaneous breathing recovery time,orientation recovery time,extubation time),recovery quality[Ricker Sedation-Agitation Scale(SAS),modified Aldrete score],postoperative analgesic effect[Visual Analogue Scale(VAS)]and drug side effects were compared between the two groups.Results The spontaneous breathing recovery time,orientation recovery time and extubation time in the observation group were shorter than those in the control group(P<0.05).The SAS score of the observation group was lower than that of the control group,and the modified Aldrete score was higher than that of the control group(P<0.05).The VAS scores of the observation group at 2,6 and 12 h after operation were lower than those of the control group(P<0.05).The incidence of adverse drug reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Low-dose esketamine has a definite analgesic effect in the general anesthesia program of laparoscopic surgery,which can shorten the recovery time of anesthesia,improve the quality of recovery,relieve postoperative pain,and have fewer side effects.