目的 探究艾司氯胺酮复合丙泊酚麻醉对腹腔镜胆囊切除术患者术后恢复、谵妄的影响。方法 选择2022年6月—2024年6月收治的92例腹腔镜胆囊切除术患者,采用随机数字表法分为两组,对照组（奇数）、观察组（偶数）各46例。对照组实施舒芬太尼复合丙泊酚麻醉,观察组实施艾司氯胺酮复合丙泊酚麻醉,比较分析两组患者生命体征（平均动脉压、心率）、术后各项恢复时间（术后苏醒时间、拔管时间、定向力恢复时间）、术后疼痛评分（视觉模拟评分法）、术后谵妄发生率。结果 麻醉诱导后、气管插管时、导管拔管时,观察组生命体征指标均高于对照组（P<0.05）;观察组术后各项恢复时间均短于对照组（P<0.05）;术后0.5、2、6、12、24 h,观察组疼痛评分（VAS评分）低于对照组（P<0.05）;观察组术后谵妄发生率小于对照组（P<0.05）。结论 腹腔镜胆囊切除术中应用艾司氯胺酮、丙泊酚复合麻醉,可稳定生命体征,缩短术后恢复时间,减轻术后疼痛症状,降低术后谵妄发生率。

Objective To investigate the effects of esketamine combined with propofol anesthesia on postoperative recovery and delirium in patients undergoing laparoscopic cholecystectomy. Methods A total of 92 patients who underwent laparoscopic cholecystectomy from June 2022 to June 2024 were selected and randomly divided into two groups using a computerized random table, with 46 cases in each group： a control group （odd numbers） and an observation group （even numbers）. The control group received sufentanil combined with propofol anesthesia, while the observation group received esketamine combined with propofol anesthesia. The study compared and analyzed vital signs （mean arterial pressure and heart rate）, postoperative recovery time （postoperatuve awakening time, extubation time, and orientation recovery time）, postoperative pain scores （by visual analog scale）, and the incidence of postoperative delirium between the two groups. Results After anesthesia induction, at tracheal intubation, and at tracheal extubation, the vital signs of the observation group were higher than those of the control group （P<0.05）. The postoperative recovery time of the observation group was shorter than that of the control group （P<0.05）. At 0.5, 2, 6, 12, and 24 h postoperatively, the pain scores （VAS scores） of the observation group were lower than those of the control group （P<0.05）. The incidence of postoperative delirium in the observation group was lower than that in the control group （P<0.05）. Conclusion The use of esketamine combined with propofol anesthesia during laparoscopic cholecystectomy can stabilize vital signs, shorten postoperative recovery time, reduce postoperative pain symptoms, and lower the incidence of postoperative delirium.