艾司氯胺酮对腹腔镜减重手术患者苏醒期躁动的影响

The Effect of Esketamine on Awakening Restlessness in Patients Undergo⁃ing Laparoscopic Weight Loss Surgery

目的 探讨艾司氯胺酮对腹腔镜减重手术患者苏醒期躁动的影响。方法 回顾性选取2021年2月—2023年1月在江苏省人民医院行腹腔镜减重手术的112例患者临床资料,根据麻醉诱导前不同干预方案将患者分为两组,每组56例。所有患者都给予全身麻醉,艾司氯胺酮组在麻醉诱导前使用艾司氯胺酮注射液,对照组在麻醉诱导前使用丙泊酚,比较两组疼痛评分、手术情况、苏醒期躁动评分。结果 艾司氯胺酮组的术后6 h视觉模拟评分法评分为(2.83±0.16)分,低于对照组的(4.32±0.21)分,差异有统计学意义(t=42.234,P<0.05)。艾司氯胺酮组与对照组手术时间对比,差异无统计学意义(P>0.05)。艾司氯胺酮组的术后拔管时间、术后停药到睁眼时间、术后苏醒时间、术后自主呼吸恢复时间均短于对照组,差异有统计学意义(P均<0.05)。艾司氯胺酮组的术后苏醒期躁动评分明显低于对照组,差异有统计学意义(P<0.05)。结论 艾司氯胺酮在腹腔镜减重手术患者的应用能缓解疼痛,也可降低术后苏醒期躁动评分,有效预防苏醒期躁动的发生。

Objective To explore the effect of esketamine on awakening restlessness in patients undergoing laparo-scopic weight loss surgery.Methods Clinical data of 112 patients who underwent laparoscopic weight loss surgery in Jiangsu Provincial People's Hospital from February 2021 to January 2023 were retrospectively selected,and the pa-tients were divided into two groups according to different intervention plans before anesthesia induction,with 56 cases in each group.All patients were given general anesthesia.The esketamine group received Esketamine injection before anesthesia induction,and the control group received propofol before anesthesia induction.Compared pain scores,sur-gical conditions,and agitation scores during awakening between the two groups.Results The Visual Analogue Scale Score of the esketamine group at 6 h after operation was 2.83±0.16,which was lower than 4.32±0.21 of the control group,and the difference was statistically significant(t=42.234,P<0.05).There was no significant difference in opera-tion time between esketamine group and control group(P>0.05).The postoperative extubation time,postoperative with-drawal time to eye opening time,postoperative recovery time and postoperative spontaneous breathing recovery time in esketamine group were shorter than those in control group,and the differences were statistically significant(all P<0.05).The postoperative agitation score of esketamine group was significantly lower than that of control group,and the difference was statistically significant(P<0.05).Conclusion The application of esketamine in patients undergoing laparoscopic weight loss surgery can alleviate pain,and also reduce postoperative restlessness scores during the recov-ery period,effectively preventing the occurrence of restlessness during the recovery period.