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| 艾司氯胺酮减少丙泊酚注射痛的效果 |
| Effect of esketamine in reducing the pain of propofol injection |
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| DOI：10.12089/jca.2023.11.007 |
| 中文关键词: 艾司氯胺酮 丙泊酚注射痛 剂量 时间间隔 效果 |
| 英文关键词: Esketamine Propofol injection pain Doses Time intervals Effect |
| 基金项目:渭南市科技计划项目（2022ZDYFJH-33） |
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| 摘要点击次数: 821 |
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| 中文摘要: |
目的 使用析因设计分析在静脉注射丙泊酚之前，使用不同剂量的艾司氯胺酮，以及使用不同间隔时间，对丙泊酚注射痛（PIP）的影响。
方法 选择择期全麻手术患者360例，男167例，女193例，年龄18～64岁，BMI 18～30 kg/m2，ASA Ⅰ—Ⅲ 级。采用随机数字表法将患者分为三组：艾司氯胺酮0.05 mg/kg（A组），艾司氯胺酮0.075 mg/kg（B组），艾司氯胺酮0.1 mg/kg（C组），每组120例。每组再随机分为3个亚组，每个亚组40例。A1组、A2组、A3组在麻醉诱导静脉注射艾司氯胺酮0.05 mg/kg后，分别间隔30 s、45 s、1 min后，静脉注射丙泊酚。B1组、B2组、B3组在麻醉诱导静脉注射艾司氯胺酮0.075 mg/kg后，分别间隔30 s、45 s、1 min后，静脉注射丙泊酚。C1组、C2组、C3组在麻醉诱导静脉注射艾司氯胺酮0.1 mg/kg后，分别间隔30 s、45 s、1 min后，静脉注射丙泊酚。采用McCririck量表评价PIP发生情况。记录术中丙泊酚诱导剂量，术后恶心呕吐、呼吸遗忘、烦躁不安、意识模糊、情绪低落等不良反应发生情况。
结果 使用不同剂量艾司氯胺酮、间隔不同时间对减少PIP比较，差异均有统计学意义（P＜0.05）。不同剂量艾司氯胺酮与不同间隔时间有交互作用（P＜0.05）。九组患者丙泊酚诱导剂量、术后恶心呕吐、呼吸遗忘、烦躁不安、意识模糊、情绪低落等不良反应发生率差异无统计学意义。
结论 与艾司氯胺酮0.05、0.1 mg/kg以及间隔时间30 s、1 min比较，使用艾司氯胺酮0.075 mg/kg、间隔时间45 s后静脉注射丙泊酚，可有效抑制PIP，无明显不良反应发生。 |
| 英文摘要: |
Objective To analyze the effect of different doses of esketamine and different time intervals on reducing propofol injection pain (PIP) before intravenous propofol using factorial design.
Methods A total of 360 elective general anesthesia surgical patients, 167 males and 193 females, aged 18-64 years, BMI 18-30 kg/m2, ASA physical status Ⅰ—Ⅲ were selected. Randomized numerical table method was used to divide the patients into three groups: esketamine 0.05 mg/kg (group A), esketamine 0.075 mg/kg (group B), and esketamine 0.1 mg/kg (group C), 120 cases in each group. Each group was further randomly divided into 3 subgroups with 40 cases in each. Groups A1, A2, and A3 received intravenous propofol after induction of anesthesia with intravenous esketamine 0.05 mg/kg at intervals of 30 seconds, 45 seconds, and 1 minute respectively. Groups B1, B2, and B3 received intravenous propofol after induction of anesthesia with intravenous esketamine 0.075 mg/kg at intervals of 30 seconds, 45 seconds, and 1 minute respectively. Groups C1, C2, and C3 received intravenous propofol after induction of anesthesia with intravenous esketamine 0.1 mg/kg at intervals of 30 seconds, 45 seconds, and 1 minute respectively. The McCririck scale was used to evaluate the occurrence of PIP. The induced dose of propofol, postoperative nausea and vomiting, respiratory amnesia, irritability, confusion, depressed and other adverse reactions were recorded.
Results Comparison of the use of different doses of esketamine or different time intervals on the reduction of PIP showed a statistically significant difference respectively (P < 0.05). There was an interaction between different doses of esketamine and different intervals (P < 0.05). There were no significant differences in propofol induction dose and adverse reactions such as, postoperative nausea and vomiting, respiratory amnesia, irritability, confusion, depressed in nine groups of patients.
Conclusion Compared with esketamine 0.05 and 0.1 mg/kg and intervals of 30 seconds and 1 minute, the use of esketamine 0.075 mg/kg and intervals of 45 seconds followed by intravenous propofol is effective in suppressing PIP without the occurrence of significant adverse effects. |
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