摘要
目的探讨艾司氯胺酮多模式干预对胸腔镜肺癌根治术后患者围术期应激反应及术后疼痛的影响。方法选择2021年1月—2023年12月本院收治的行胸腔镜肺癌根治术的患者60例作为研究对象,随机数表法分为艾司氯胺酮组(E组)和空白对照组(N组)两组,每组各30例。E组术中及术后使用艾司氯胺酮行多模式镇痛,N组给与相同剂量生理盐水,分别在苏醒时(T_(0))术后6 h(T_(1))、12 h(T_(2))、24 h(T_(3))及48 h(T_(4))的采用视觉模拟评分法(Visual analogue scale,VAS)评分评价镇痛效果;检测两组患者的血清去甲肾上腺素(NE)和皮质醇(Cor)浓度;记录两组患者不良反应发生情况。结果两组患者T_(2~3)时VAS评分及NE、Cor在T_(3~4)时表达明显高于T_1时(P<0.05);E组患者T_(1~3)时VAS评分及T_(3~4)时NE、Cor表达明显低于N组(P<0.05);此外,E组患者镇痛泵按压次数明显少于N组(P<0.05);结论艾司氯胺酮多模式镇痛可明显减轻胸腔镜肺癌根治术后疼痛减轻围术期应激反应,有利于患者快速康复。
Objective To investigate the effects of esketamine multimodal intervention on perioperative stress response and postoperative pain in patients after thoracoscopic radical lung cancer surgery.Methods A total of 60 patients undergoing thoracoscopic radical lung surgery at our hospital from January 2021 to December 2023 were randomly divided into two groups:esketamine group(group E)and blank control group(group N),with 30 cases in each group.Group E underwent multi-mode analgesia with esketamine during and after surgery,group N was given the same dose of normal saline,and visual analogue scale was adopted at 6h(T_(1)),12 h(T_(2)),24 h(T_(3))and 48 h(T_(4))after recovery(T_(0)),respectively.VAS score was used to evaluate the analgesic effect.Serum norepinephrine(NE)and cortisol(Cor)concentrations were detected in two groups.The occurrence of adverse reactions was recorded in the two groups.Results VAS scores and the expression of NE and Cor at T_(2~3)were significantly higher than those at T_(1)(P<0.05).The VAS scores at T_(1~3)and the expressions of NE and Cor at T_(3-4)in group E were significantly lower than those in group N(P<0.05).In addition,the number of analgesic pump compressions in group E was significantly less than that in group N(P<0.05).Conclusions Multi-mode analgesia with esketamine can significantly relieve pain and stress reaction during perioperative period after thoracoscopic radical lung cancer surgery,which is conducive to rapid recovery of patients.
作者
张代玲
潘鹏
赵赢
晋维林
Zhang Dailing;Pan Peng;Zhao Ying;Jin Weilin(Department of Anesthesiology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan,Jiangsu215300,China)
出处
《齐齐哈尔医学院学报》
2025年第11期1053-1056,共4页
Journal of Qiqihar Medical University
基金
苏州市科技发展计划项目(SKY2023091)。
关键词
艾司氯胺酮
胸腔镜
肺癌根治术
应激反应
Esketamine
Thoracoscope
Radical resection of lung cancer
Stress response
作者简介
通信作者:晋维林,Email:yuanyueyuan521@163.com。
