低剂量艾司氯胺酮在气管插管全麻甲状腺切除术中的应用价值

Application value of low-dose esketaminein tracheal general anesthesia thyroidectomy

目的 探讨低剂量艾司氯胺酮在气管插管全麻甲状腺切除术中的应用价值。方法 选取自2021年7月至2023年1月在本院接受甲状腺切除术的96例患者,采用随机分组法(信封法)分为对照组和观察组,每组48例。两组均给予气管插管全麻,其中观察组给予低剂量艾司氯胺酮,观察两组麻醉时间、手术时间、患者睁眼时间等,以及不同时间点血流动力学参数等差异。结果 观察组和对照组的麻醉时间、拔管时间、睁眼时间、手术时间差异均无统计学意义(P>0.05)。观察组静脉给药后5 min平均动脉压(MAP)、心率(HR)明显高于对照组(P<0.05),而拔管时、拔管后5 min MAP、HR明显低于对照组(P<0.05);观察组术后呛咳发生率低于对照组(P<0.05)。观察组术后3 d时自评焦虑(SAS)评分和自评抑郁(SDS)评分低于对照组(P<0.05)。观察组术后1 d和3 d时引流量低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论 低剂量艾司氯胺酮在气管插管全麻甲状腺切除术中有较好的应用价值,可降低患者术后呛咳反应及引流量,改善患者情绪。

Objective To explore the application value of low-dose esketamine in tracheal intubation and general anesthesia for thyroidectomy.Methods From July 2021 to January 2023,96 patients who underwent thyroidectomy inthe hospital were divided into 2 groups:an observation group(48 patients) and a control group(48 patients),using the envelope method.Both groups underwent tracheal intubation and general anesthesia for the surgery.Additionally,the observation group received low-dose esketamine.The study focused on comparing anesthesia time,surgical time,and eye-opening time between the 2 groups,along with differences in hemodynamic parameters at various time points.Results There was no statistically significant difference in anesthesia time,extubation time,eye opening time and surgical time between observation group and control group(P>0.05).The mean arterial pressure(MAP) and heart rate(HR) at 5 min after intravenous administration in observation group were significantly higher than those in control group(P<0.05),but at extubation and 5 min after extubation,MAP and HR were significantly lower than those in control group(P<0.05).The incidence of postoperative cough in observation group was lower than that in control group(P<0.05).The self-rated anxiety(SAS) score and self-rated depression(SDS) score of the observation group were lower than those of the control group at 3 days after operation(P<0.05).The drainage volume of the observation group was lower than that of the control group at 1 and 3 days after operation(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Low dose esketamine has good application value in tracheal intubation general anesthesia thyroidectomy,reducing postoperative cough response and drainage volume,improving patients′ emotional status.