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| 右旋氯胺酮在心血管手术的临床应用 |
| Research advances of s-ketamine in patients undergoing cardiovascular surgery |
| 投稿时间：2023-08-02 修订日期：2024-02-17 |
| DOI： |
| 中文关键词: 右旋氯胺酮 临床麻醉 心血管手术 心肌保护 |
| 英文关键词: S-ketamine Clinical Anesthesia Cardiovascular surgery Cardiac protection |
| 基金项目:天津市科技计划项目多元面上项目(21JCYBJC01190)；国家自然科学基金面上项目(82072219)；天津市医学重点学科(TJYXZDXK-045A) |
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| 中文摘要: |
| 右旋氯胺酮是氯胺酮的旋光异构体，兼有镇静、镇痛和遗忘三重作用，在药效、可控性和副作用等方面均优于消旋氯胺酮。目前已在欧美等国家广泛应用于麻醉、急救及重症等领域，在我国临床多用于镇静、镇痛、抗抑郁等。右旋氯胺酮用于心脏手术可以维持稳定的血流动力学、减少炎症因子分泌以及缓解术后疼痛等。其拟交感神经作用使其可以应用于血流动力学不稳定及急性心梗患者的麻醉诱导。本文综述了右旋氯胺酮用于心血管手术围术期临床应用价值和局限性，为临床医生在心血管手术围术期使用右旋氯胺酮提供参考。 |
| 英文摘要: |
| S-ketamine is a spin isomer of ketamine, which has the triple effect of sedation, analgesia and amnesia, and is superior to ablative ketamine in terms of efficacy, controllability and side effects. It has been widely used in anesthesia, emergency and critical care in Europe and America, and is mostly used for sedation, analgesia and antidepressant in China. S-ketamine is used in cardiac surgery to maintain stable hemodynamics, reduce the secretion of inflammatory factors and relieve postoperative pain. Its sympathomimetic effect allows it to be used for the induction of anesthesia in patients with hemodynamic instability and acute heart attack. This paper reviews the recent advance in the clinical value and limitations of s-ketamine in the perioperative period of cardiovascular surgery and provides a reference for clinicians to use s-ketamine in the perioperative period of Cardiovascular surgery. |
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