不同剂量艾司氯胺酮对甲状腺癌根治术后患者疼痛和情绪的影响

Effects of different doses of Espex Ketamine on pain and emotion in patients undergoing radical thyroidectomy

目的 探讨不同剂量艾司氯胺酮对甲状腺癌根治术后患者疼痛和情绪的影响。方法选取收治的80例行甲状腺癌根治术治疗者作为研究对象,将其随机分为两组,对照组40例于麻醉诱导后,行小剂量艾司氯胺酮治疗,观察组40例患者则在麻醉诱导后,行高剂量艾司氯胺酮治疗,对两组的麻醉情况进行对比。结果 两组麻醉时间、拔管时间、拔管后即刻的Ramsay镇静评分、术中瑞芬太尼用量对比均无明显差异(P>0.05);术后24h时痛觉视觉模拟量表(Visual analogue scale,VAS)评分比较,观察组明显低于对照组(P<0.05);术后48h比较,观察组焦虑、抑郁评分均低于对照组(P<0.05);术后48h,观察组术后恢复质量量表-40(Quality of recovery-40,QoR-40)中情绪状态、心理支持维持评分及总评分均高于对照组(P<0.05);术后不良反应对比无明显差异(P>0.05)。结论 高剂量艾司氯胺酮在甲状腺癌根治术中的应用效果更理想,能够起到更好地镇痛、改善患者负面情绪的作用。

Objective To investigate the effects of different doses of Esperanza Ketamine on spain and emotion in patients undergoing radical thyroidectomy for thyroid cancer.Methods 80 patients who received radical thyroidectomy were randomly divided into two groups.The control group(40 patients)received low-dose Ketamine after anesthesia induction,and the observation group(40 patients)received high-dose Ketamine after anesthesia induction.Results There was no significant difference in anesthesia time,extubation time,Ramsay sedation score immediately after extubation,and intraoperative remifentanil dosage between the two groups(P>0.05).At 24 hours after surgery,the visual analog scale(VAS)scores in the observation group were significantly lower than those in the control group(P<0.05).Compared 48 hours after surgery,the anxiety and depression scores of the observation group were lower than those of the control group(P<0.05).48 hours after surgery,the emotional state,psychological support maintenance score,and total score in the observation group's postoperative recovery quality scale-40(QoR-40)were higher than those in the control group(P<0.05).There was no significant difference in postoperative adverse reactions(P>0.05).Conclusion High-dose Ketamine is more effective in the application of thyroid cancer radical surgery,which can play a better role in analgesia and improving patients' negative emotions.