摘要
氯胺酮是由等量的左旋氯胺酮和右旋氯胺酮混合而成的消旋混合物。其作为麻醉剂使用已经有悠久的历史,具有缓解焦虑、降低自杀意念、治疗慢性疼痛等多种作用。但是氯胺酮的广泛应用受限于头晕、恶心、血压升高等不良反应以及可能的滥用潜力。艾司氯胺酮是近年来在国内上市的热点药物。作为氯胺酮的右旋异构体,艾司氯胺酮在具有上述作用的同时不良反应发生率更低,患者的耐受性更好,使其在精神治疗领域以及麻醉领域的多个临床环境都具有广阔的应用前景。因此本文就艾司氯胺酮在围手术期的应用、药理学特性等方面作一综述,简述艾司氯胺酮的药理学作用以及可能的机制,并介绍艾司氯胺酮在围手术期中镇静、镇痛和抗焦虑抑郁中的临床应用进展。本文探讨艾司氯胺酮在围手术期中的应用前景,以期能为艾司氯胺酮的推广应用提供借鉴和参考,并提供新的研究方向。
Ketamine is a racemic mixture composed of an equal amount of L-ketamine and D-ketamine.It has a long history of use as an anesthetic,with various effects such as relieving anxiety,reducing suicidal ideation,and treating chronic pain.However,the widespread use of ketamine is limited by adverse reactions such as dizziness,nausea,elevated blood pressure,and potential abuse.Esketamine has been a hot drug on the domestic market in recent years.As a right-handed isomer of ketamine,Esketamine has the aforementioned effects while reducing the incidence of adverse reactions and improving patient tolerance.It has broad application prospects in multiple clinical environments in the fields of psychotherapy and anesthesia.Therefore,this article provides a review of the application and pharmacological characteristics of ketamine during the perioperative period,briefly describing the pharmacological effects and possible mechanisms of ketamine,and introduces the clinical application progress of ketamine in sedation,analgesia,and anti anxiety and depression during the perioperative period.This article also explores the application prospects of ketamine in the perioperative period,in order to provide reference and guidance for the promotion and application of ketamine,and to provide new research directions.
作者
王道杰
吴多志
丁容
Wang Daojie;Wu Duozhi;Ding Rong(Department of Anesthesiology,Hainan General Hospital,Haikou 570311,China)
出处
《中国医师杂志》
CAS
2024年第1期150-155,共6页
Journal of Chinese Physician
基金
海南省卫生健康行业科研项目(22A200217)。
作者简介
通信作者:吴多志,Email:13976674619@163.com。
