艾司氯胺酮联合硫酸镁在肥胖患者腹腔镜袖状胃切除术中的应用OA

Objective To investigate the effects of esketamine combined with magnesium sulfate on intraoperative anesthetic consumption,extubation outcome,and postoperative analgesic efficacy in obese patients undergoing laparoscopic sleeve gas-trectomy.Methods A total of 160 obese patients undergoing elective laparoscopic sleeve gastrectomy from April 2023 to February 2025 were selected.They were randomly divided into two groups using a random number table:the esketamine combined with magnesium sulfate group(SKM group,n=80)and the esketamine group(SK group,n=80).The SKM group received intravenous esketamine at a dose of 0.5 mg/kg before anesthesia induction,followed by a continuous infusion at a rate of 0.3 mg·kg-1·h-1.Simultaneously,they were administered intravenous magnesium sulfate at 50 mg/kg,sub-sequently infused continuously at a rate of 8 mg·kg-1·h-1.The SK group received only an equivalent dose of esketamine,administered in the same manner as the SKM group.All patients underwent a standardized general anesthesia protocol.The intraoperative consumption of ciprofol and remifentanil and extubation time were recorded for both groups.In the post-anes-thesia care unit(PACU),resting pain Visual Analog Scale(VAS)scores,the number of cases requiring tramadol rescue analgesia,and its dosage were documented.Additionally,the incidence of adverse reactions such as respiratory depression,arrhythmia,and drowsiness within 24 hours postoperatively,as well as the number of effective patient-controlled analgesia(PCA)pump presses within 48 hours postoperatively,were recorded.Results Compared with the SK group,the SKM group demonstrated reduced intraoperative consumption of ciprofol and remifentanil and shorter extubation time(P＜0.05).The SKM group had lower resting VAS scores,as well as a lower rate and dosage of tramadol rescue analgesia during the PACU stay(P＜0.05).There was no significant difference in the incidence of adverse reactions within 24 hours postopera-tively between the two groups.The number of PCA pump presses within 48 hours postoperatively in the SKM group was low-er than that in the SK group(P＜0.05).Conclusion The anesthetic regimen of esketamine combined with magnesium sul-fate can safely and effectively reduce the intraoperative consumption of sedative and opioid drugs during laparoscopic sleeve gastrectomy,facilitate postoperative recovery,and provide superior postoperative analgesia without increasing the incidence of related adverse reactions.