艾司氯胺酮在腹腔镜全身麻醉手术中的应用效果研究

Application of Esketamine in Laparoscopic General Anesthesia

目的研究艾司氯胺酮在腹腔镜全身麻醉手术中的应用效果。方法方便选取2021年3月—2023年10月于江苏省如东县中医院行腹腔镜全身麻醉的166例患者作为研究对象,按照入院顺序进行编号,并随机分为对照组(83例)与观察组(83例)。对照组予以常规全身麻醉,研究组在对照组基础上予以艾司氯胺酮麻醉。比较两组患者的生命体征指标、围术期指标、术后疼痛程度及术后不良反应发生情况。结果在麻醉实施后30 min,观察组动脉血氧饱和度高于对照组,且平均动脉压、心率均低于对照组,差异有统计学意义(t=2.834、1.989、3.317,P均<0.05)。观察组麻醉应答时间、手术时间、排气时间及术后24 h疼痛评分均优于对照组,差异有统计学意义(t=2.214、2.657、1.998、2.193,P均<0.05);观察组术后嗜睡、暴躁、胃肠不适、意识模糊等不良反应总发生率(3.61%)低于对照组(13.25%),差异有统计学意义(χ^(2)=4.992,P<0.05)。结论在腹腔镜全麻手术中,选择艾司氯胺酮进行麻醉能够获得更好的效果,患者手术期间生命体征更稳定,麻醉应答时间更短,术后疼痛感水平更低,具有更高的安全性。

Objective To study the effect of esketamine in laparoscopic general anesthesia.Methods A total of one hundred and sixty-six patients who underwent laparoscopic general anesthesia in Rudong County Hospital of Traditional Chinese Medicine in Jiangsu Province from March 2021 to October 2023 were selected conveniently as the research subjects.They were numbered according to the order of admission and randomly divided into control group(83 cases)and observation group(83 cases).The control group was given general anesthesia,and the observation group was given esketamine anesthesia on the basis of the control group.The vital signs,perioperative indicators,postoperative pain level,and incidence of postoperative adverse reactions of patients in two groups were compared.Results At 30 min after anesthesia,the arterial oxygen saturation of the observation group was higher than that of the control group,and the mean arterial pressure and heart rate of the observation group were lower than that of the control group,and the differences were statistically significant(t=2.834,1.989,3.317,all P<0.05).Anesthesia response time,operation time,exhaust time and 24 h postoperative pain score in the observation group were better than those in the control group,and the differences were statistically significant(t=2.214,2.657,1.998,2.193,all P<0.05).The total incidence of postoperative adverse reactions such as drowsiness,irritability,gastrointestinal discomfort,and confusion in the observation group(3.61%)was lower than that in the control group(13.25%),and the difference was statistically significant(χ^(2)=4.992,P<0.05).Conclusion In laparoscopic general anesthesia,esketamine anesthesia can obtain better results,and patients'vital signs during surgery are more stable,anesthesia takes effect faster,postoperative pain is lower,and has higher safety.