艾司氯胺酮联合舒芬太尼对行腹腔镜下卵巢根治术治疗患者术后镇痛效果及血流动力学的影响

Eeffect of Esketamine combined with sufentanil on postoperative analgesia and hemodynamics in patients undergoing laparoscopic radical ovariectomy

目的 探讨艾司氯胺酮联合舒芬太尼对行腹腔镜下卵巢根治术治疗患者术后镇痛效果及血流动力学的影响。方法 选取2021年1月—2022年12月在我院进行腹腔镜下卵巢根治手术的72例患者。按照随机数字表法将其分为观察组与对照组,每组36例患者。对照组在患者手术后使用舒芬太尼进行镇痛,观察组使用艾司氯胺酮联合舒芬太尼进行镇痛。比较二组患者血流动力学指标、疼痛程度、术后拔管时间、苏醒时间、应激指标以及不良反应。结果 二组患者在T0、T3时期的心率(HR)、平均动脉压(MAP)指标无统计学意义(P>0.05),而在T1、T2时期,观察组患者的HR、MAP指标明显的低于对照组患者,有统计学意义(P<0.05);二组患者的视觉模拟评分(VAS)均呈现出先升高后降低的趋势,在术后的4h、48h,观察组VAS评分低于对照组患者,无统计学意义(P>0.05),而手术后的8h、12h以及24h,观察组的评分明显的低于对照组患者,有统计学意义(P<0.05);观察组患者的术后拔管时间以及苏醒时间均明显的低于对照组患者,有统计学意义(P<0.05);观察组患者的不良反应明显的低于对照组患者,有统计学意义(P<0.05)。结论对于进行腹腔镜下卵巢根治术的患者使用艾司氯胺酮联合舒芬太尼进行治疗可以改善患者血流动力学指标,明显的降低患者的疼痛程度。

Objective To investigate the effect of Esketamine combined with Sufentanil on postoperative analgesia and hemodynamics in patients undergoing laparoscopic radical ovariectomy. Methods Seventy-two patients who underwent laparoscopic radical ovariectomy in our hospital from January 2021 to December 2022 were selected.According to random number table method, they were divided into observation group and control group, with 36 patients in each group.The control group received sufentanil for analgesia after surgery, and the observation group received esketamine combined with sufentanil for analgesia.Hemodynamic indexes, pain degree, postoperative extubation time, recovery time, stress indexes and adverse reactions were compared between the two groups. Results There was no statistical difference in HR and MAP indexes between the two groups in the T0 and T3 periods(P>0.05),while in the T1 and T2 periods, HR and MAP indexes in the observation group were significantly lower than those in the control group(P<0.05).VAS score of both groups showed a trend of first increasing and then decreasing.At 4h and 48h after surgery, VAS score of observation group was lower than that of control group without significant difference(P>0.05),while at 8h, 12h and 24h after surgery, VAS score of observation group was significantly lower than that of control group, with statistical difference(P<0.05).Postoperative extubation time and recovery time of observation group were significantly lower than control group, with statistical difference(P<0.05).The adverse reactions in observation group were significantly lower than those in control group(P<0.05). Conclusion For patients undergoing laparoscopic radical ovariectomy, esketamine combined with sufentanil can significantly reduce the degree of pain and improve hemodynamic indexes, which is worthy of clinical promotion.