艾司氯胺酮泵注对老年全麻患者术中循环影响的临床观察

doi:10.3969/j.issn.2095-378X.2023.02.011

Abstract

Abstract: Objective To observe the influence of intraoperative infusion of Spravato on improving circulation stability in elderly patients under general anesthesia. Methods A total of 83 elderly patients who received general anesthesia surgery from May 2021 to October 2022 were selected, and were divided into an experimental group of 41 cases and a conventional group of 42 cases by random number table method. The conventional group received routine target-controlled intravenous general anesthesia and selected normal saline for goal-directed fluid therapy. The experimental group received general anesthesia treatment as the conventional group, and selected intraoperative infusion of Spravato for goal-directed fluid therapy. The mean arterial pressure （MAP） and heart rate （HR） before anesthesia induction （T1）, before endotracheal intubation （T2）, 1 min after intubation （T3）, and 10 min after intubation （T4）, as well as postoperative pain, sedation, and adverse reactions were compared between the two groups. Results The MAP and HR at T2, T3, and T4 of the experimental group compared with the conventional group were significantly lower （all P<0.05）. The VAS scores at 1 h, 2 h, and 6 h after operation in the experimental group were significantly lower than those in the conventional group （all P<0.05）. The Ramsay scores at 1 h and 2 h after operation in the experimental group were significantly higher than those in the conventional group （all P<0.05）. The total incidence of adverse reactions in the experimental group was significantly lower than that in the conventional group （all P<0.05）. Conclusion Intraoperative infusion of Spravato can effectively maintain the stability of circulation in elderly patients under general anesthesia, improve the effect of analgesia and sedation, and reduce the risk of adverse reactions.

Key words: General anesthesia, Elderly, Spravato, Intraoperative infusion, Circulation stability

CLC Number:

R614

LIU Shuai. Clinical observation of intraoperative infusion of Spravato on improving circulation in elderly patients undergoing general anesthesia[J]. Surgical Research and New Technique, 2023, 12(2): 118-121.

References

[1] 丰浩荣,陈子彬,何通,等.艾司氯胺酮混合芬太尼用于肥胖患儿隐匿性阴茎矫正术后PCIA的效果[J].中华麻醉学杂志,2021,41(12):1532-1533.
[2] 颜景佳,黄琦萍,陈清霞,等.艾司氯胺酮或纳布啡用于胸椎旁阻滞前的镇痛效果及对R-A-A-S的影响[J].重庆医学,2022,51(5):820-824.
[3] 刘晓东,刘国艳,王存斌.右美托咪定缓解膝关节置换术后全身麻醉老年患者苏醒期躁动的效果分析[J].重庆医学,2018,47(4):535-537.
[4] 史文艳,徐洁蕾,袁城栋,等.不同麻醉方式下行鼻内镜手术治疗老年慢性鼻窦炎的效果及对应激反应和嗅觉功能的影响[J].中国老年学杂志,2021,41(11):2325-2328.
[5] 郑继根,武琳智,邹鲁宏,等.小剂量艾司氯胺酮与右美托咪定对剖宫产术后产妇忧郁和疼痛的疗效比较[J].重庆医学,2022,51(12):2045-2050.
[6] 王晓东,于明涛,刘子强,等.苯磺酸瑞马唑仑联合艾司氯胺酮静脉麻醉在内镜下逆行胰胆管造影术中的临床应用[J].中国医刊,2021,56(3):274-277.
[7] 张仲金,薛静,王孝军.前列腺电切术全麻与经蛛网膜下隙-硬膜外联合麻醉用于老年患者的临床效果[J].中国老年学杂志,2021,41(23):5223-5225.
[8] 伍剑锷,汪文华,赖尚树,等.B超引导下神经阻滞麻醉对老年髋关节手术患者神经阻滞效果及认知功能的影响[J].中国老年学杂志,2018,38(9):2130-2133.
[9] 夏良勇,李蕾,董春山,等.胸椎旁阻滞联合肋缘下腹横肌平面阻滞在老年全麻下腔镜食管癌根治术中的效果[J].中国老年学杂志,2022,42(13):3207-3210.
[10] 赵聪,尹泓,李红梅,等.不同剂量右美托咪定复合罗哌卡因胸椎旁神经阻滞对老年胸腔镜手术患者术后镇痛的影响[J].中国老年学杂志,2022,42(9):2140-2143.
[11] 孙蓓,陈利海,丁可,等.诱导期使用羟考酮对老年经尿道前列腺绿激光汽化术患者麻醉效果的影响[J].临床麻醉学杂志,2020,36(7):643-646.
[12] 肖琼瑶,张娇.不同麻醉方法对围术期老年患者术后认知功能的影响及作用机制[J].中国老年学杂志,2020,40(14):3006-3009.
[13] 徐晶晶,李娟,程豪.超声引导下腰方肌前路阻滞复合静脉全麻在老年结肠癌根治术患者中的应用[J].中国老年学杂志,2021,41(21):4718-4721.
[14] 周斌,余艳丽,邱珍,等.艾司氯胺酮在老年患者去阿片全身麻醉诱导中的应用[J].中国新药与临床杂志,2022,41(3):162-166.
[15] 沈燕平,殷利军,庄文明,等.艾司氯胺酮预防无痛人工流产术中丙泊酚注射痛的有效剂量[J].中国临床药理学与治疗学,2022,27(6):660-664.
[16] 李春林,沈阳,许亚菲,等.不同剂量艾司氯胺酮复合丙泊酚应用于胃镜检查的临床观察[J].中国新药杂志,2022,31(8):773-777.
[17] 郝玉娟,胡胜红,王胜斌,等.低剂量艾司氯胺酮对甲状腺切除术后苏醒期气管导管呛咳反应的影响[J].实用医学杂志,2021,37(21):2791-2794.
[18] 王欣,孙合亮,张庆伟,等.小剂量艾司氯胺酮在胸腔镜下肺叶切除术患者术后镇痛中的作用[J].中国临床药理学与治疗学,2022,27(9):998-1003.

Clinical observation of intraoperative infusion of Spravato on improving circulation in elderly patients undergoing general anesthesia

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