亚麻醉剂量艾司氯胺酮在妇科腹腔镜手术患者中的应用效果

Application effect of subanesthetic dose of Esketamine in gyne-cological laparoscopic surgery

目的探讨亚麻醉剂量艾司氯胺酮在妇科腹腔镜手术患者中的应用效果。方法选取2021年9月至2022年6月于山东大学附属生殖医院行妇科腹腔镜手术的100例住院患者,按照随机数字表法分为试验组和对照组,每组各50例。试验组给予艾司氯胺酮0.5 mg/kg联合术中艾司氯胺酮0.125 mg/(kg·h)持续注射,对照组输注等容量0.9%氯化钠注射液。比较两组恢复质量、疼痛程度及不良反应发生情况。结果术后第1天及术后第3天,试验组恢复质量15项量表评分高于对照组(P<0.05)。术后2、4、6及12 h,试验组疼痛数字评分量表评分均低于对照组(P<0.05)。两组恶心、呕吐发生率比较,差异无统计学意义(P>0.05)。试验组嗜睡发生率高于对照组(P<0.05)。结论亚麻醉剂量艾司氯胺酮可有效提高妇科腹腔镜手术患者的术后恢复质量,减少术后疼痛,且不会增加恶心、呕吐的发生风险,值得推广。

Objective To investigate the application effect of subanesthetic dose of Esketamine in gynecological laparoscopic surgery.Methods A total of 100 hospitalized patients undergoing gynecological laparoscopic surgery in the Hospital for Reproductive Medicine Affiliated to Shandong University from September 2021 to June 2022 were selected and divided into the experimental group and the control group according to the random number table method,with 50 cases in each group.The experimental group was given 0.5 mg/kg Esketamine combined with 0.125 mg/(kg·h)continuous intraoperative Esketamine injection,and the control group was given equal volume of 0.9%sodium chloride injection.The recovery quality,pain degree and occurrence of adverse reactions were compared between the two groups.Results On the first and third day after surgery,the scores of 15-item quality of recovery questionnaire in the experimental group were higher than those in the control group(P<0.05).At 2,4,6 and 12 h after operation,the scores of numerical rating scale in the experimental group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of nausea and vomiting between the two groups(P>0.05).The incidence of sleepiness in the experimental group was higher than that in the control group(P<0.05).Conclusion The subanesthetic dose of Esketamine can effectively improve the postoperative recovery quality of gynecological laparoscopic surgery patients,reduce postoperative pain,and does not increase the risk of nausea and vomiting,which is worthy of promotion.