艾司氯胺酮在宫腔镜手术麻醉中的应用效果

Effect of Esketamine in Anesthesia During Hysteroscopic Surgery

目的 观察宫腔镜手术麻醉中应用艾司氯胺酮的效果。方法 选择择期接受宫腔镜手术的患者120例,随机分为E组和S组,各60例,E组退出1例。静脉诱导时,E组注射艾司氯胺酮,S组注射舒芬太尼。记录两组给药前(T_0)、诱导后(T_(1))、插管时(T_(2))、插管后1 min(T_(3))、插管后5 min(T_(4))、手术结束时(T_(5))血流动力学变化,以及术中体动、追加药物次数、镇静苏醒时间、麻醉恢复时间,抑郁自评量表(SDS)评分,术后恶心呕吐、头晕、多语等不良反应例数。结果 E组收缩压(SBP)(T_(1~3)、T_(5)时刻)、舒张压(DBP)(T_(1~4)时刻),心率(HR)(T_(2~6)时刻)高于S组(P<0.05)。两组体动、追加次数、镇静苏醒时间、麻醉恢复时间、不良反应指标、SDS评分差异无统计学意义(P>0.05)。结论 艾司氯胺酮具有血流动力学稳定、不良反应少的优点,可安全用于宫腔镜手术患者的麻醉。

Objective To observe the anesthesia effect of esketamine in hysteroscopic surgery.Methods A total of 120 patients who underwent elective hysteroscopic surgery were randomly divided into group E and group S,with 60 cases in each group,and 1 case excited in group E.During intravenous induction,group E was injected with ketamine,while group S was injected with sufentanil.The hemodynamic changes before administration(T 0),after induction(T_(1)),at intubation(T_(2)),1 minute after intubation(T_(3)),5 minutes after intubation(T_(4)),and at the end of surgery(T_(5))in two groups,as well as intraoperative body movements,number of additional medications,sedation and recovery time,anesthesia recovery time,self-rating depression scale(SDS)scores,and the number of postoperative adverse reactions such as nausea,vomiting,dizziness,and multilingualism were recorded.Results The systolic blood pressure(SBP)(T_(1)-3,T_(5)),diastolic blood pressure(DBP)(T_(1)-4),and heart rate(HR)(T_(2)-6)in group E were higher than those in group S.There was no statistically difference between the two groups in terms of physical activity,additional frequency,sedation recovery time,anesthesia recovery time,adverse reaction indicators and SDS score.Conclusion Esketamine has the advantages of hemodynamic stability and few adverse reactions,and can be safely used for anesthesia in patients undergoing hysteroscopic surgery.