丙泊酚靶控输注复合艾司氯胺酮在经鼻内窥镜手术中的应用效果OA
Application effect of propofol target-controlled infusion combined with esketamine in endoscopic nasal surgery
目的 探究丙泊酚靶控输注复合艾司氯胺酮对经鼻内窥镜手术患者苏醒质量及术后疼痛的影响.方法 选取拟行鼻内窥镜手术的102例患者,随机分为观察组及对照组,各51例.对照组患者采用丙泊酚靶控输注麻醉,观察组患者采用丙泊酚靶控输注复合艾司氯胺酮麻醉.记录并比较2组患者围术期的心率(HR)、平均动脉压(MAP)变化;采用疼痛视觉模拟量表(VAS)评估患者疼痛程度;比较2组患者麻醉苏醒期的Ramsay镇静评分及苏醒期躁动发生率;统计2组患者术后恢复指标及不良反应发生情况.结果 与对照组相比,观察组患者术中各时间点的HR、MAP均更低,术后2 h、术后12 h时的VAS评分更低,Ramsay镇静评分等级高的占比更高,苏醒期躁动发生率更低,差异均有统计学意义(P<0.05).2组患者术后恢复指标及不良反应发生率比较,差异均无统计学意义(P>0.05).结论 丙泊酚靶控输注复合艾司氯胺酮用于经鼻内窥镜手术能显著减轻患者术后早期的疼痛程度,优化苏醒质量,且未显著增加术后不良反应发生风险,具有较高的临床安全性.
Objective To investigate the influence of propofol target-controlled infusion combined with esketamine on recovery quality and postoperative pain of patients undergoing endoscopic nasal surgery.Methods A total of 102 patients who were scheduled to receive endoscopic nasal surgery were selected and randomly divided into the observation group and the control group,with 51 cases in each group.Patients in the control group were anesthetized with propofol target-controlled infusion,and patients in the observation group were anesthetized with propofol target-controlled infusion combined with esketamine.The fluctuations of heart rate(HR)and mean arterial pressure(MAP)of patients during perioperative period in the two groups were recorded and compared.The visual analogue scale(VAS)was used to assess the pain degree of patients.The Ramsay sedation scores during the anesthesia recovery period and the incidence of agitation during the recovery period in the two groups of patients were compared.The postoperative recovery indicators and the occurrence of adverse reactions of the two groups of patients were statistically analyzed.Results Compared with control group,the HR and MAP of patients in the observation group at each time point during the operation were lower,the VAS scores at 2 hours and 12 hours after the operation were lower,the proportion of patients with high Ramsay sedation score was higher,and the incidence of agitation during the recovery period was lower,the differences were all statistically significant(P<0.05).There were no significant differences in the postoperative recovery indicators or the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion Propofol target-controlled infusion combined with esketamine for endoscopic nasal surgery can significantly relieve the early postoperative pain,and optimize the recovery quality,and it does not significantly increase the risk of occurrence of postoperative adverse reactions,with high clinical safety.
夏克枢;陈勇;梁孟秋;许明星
成都市第三人民医院麻醉科,四川 成都 610017成都市第三人民医院麻醉科,四川 成都 610017成都市第三人民医院麻醉科,四川 成都 610017成都市第三人民医院麻醉科,四川 成都 610017
医药卫生
丙泊酚靶控输注艾司氯胺酮经鼻内窥镜手术苏醒质量
propofoltarget-controlled infusionesketamineendoscopic nasal surgeryrecovery quality
《局解手术学杂志》 2026 (6)
483-486,4
四川省医学会镇痛镇静(宜昌人福)专项科研项目(2024RF02)
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