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| 氯胺酮和艾司氯胺酮在低阿片方案中应用的研究进展 |
| Research progress of the application of ketamine and S-ketamine in low-dose opioid therapy |
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| DOI：10.12089/jca.2023.01.017 |
| 中文关键词: 氯胺酮 艾司氯胺酮 低阿片方案 多模式镇痛 |
| 英文关键词: Ketamine S-ketamine Low-dose opioid therapy Multi-modal analgesic strategies |
| 基金项目:国家自然科学基金（81974171，81703482）；江苏省自然科学基金（BK20211382）；江苏省“双创团队”项目（JSSCTD202144） |
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| 中文摘要: |
| 随着加速康复外科的不断发展，传统麻醉方案不断改进，有学者提出减少阿片类药物使用、推广多模式镇痛，即发展低阿片麻醉方案。氯胺酮是一种具有较强镇痛效果的麻醉药物，其药理学作用主要通过非竞争性地阻断N-甲基-D-天冬氨酸（NMDA）受体。因其具有较强的镇痛作用、不良反应较少、镇痛剂量不影响呼吸及循环稳定等特点，逐渐成为围术期低阿片方案中重要的非阿片类药物。本文就氯胺酮和艾司氯胺酮在低阿片方案中的临床应用及相关机制进行综述。 |
| 英文摘要: |
| The development of enhanced recovery after surgery (ERAS) brings great challenge to conventional anesthesia management that underlies the innovation of multi-modal analgesic strategies and low-dose opioid therapy. Ketamine is an anesthetic with strong analgesia effect, the pharmacological mechanism of which has been considered to be a noncompetitive inhibitor of N-methyl-D-aspartic acid (NMDA) receptors. As a non-opioid analgesic widely used in low-dose opioid therapy, ketamine is characterized by analgesic effects, less side effects and has little effect on the respiratory and circulation system. This article is to discuss the clinical applications and mechanisms of ketamine and S-ketamine in low-dose opioid therapy. |
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