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| 艾司氯胺酮在围术期多模式镇痛中的研究进展 |
| Research progress of esketamine in perioperative multimodal analgesia |
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| DOI：10.12089/jca.2025.12.015 |
| 中文关键词: 艾司氯胺酮 多模式镇痛 N-甲基-D-天冬氨酸拮抗药 术后疼痛 |
| 英文关键词: Esketamine Multimodal analgesia N-methyl-D-aspartate receptor antagonist Post-operative pain |
| 基金项目: |
| 作者 | 单位 | E-mail | | 郭仁浜 | 570311,海口市,海南省人民医院（海南医科大学附属海南医院）麻醉科 | | | 林冠文 | 570311,海口市,海南省人民医院（海南医科大学附属海南医院）麻醉科 | | | 高伟 | 570311,海口市,海南省人民医院（海南医科大学附属海南医院）麻醉科 | | | 林娅美 | 570311,海口市,海南省人民医院（海南医科大学附属海南医院）麻醉科 | | | 吴多志 | 570311,海口市,海南省人民医院（海南医科大学附属海南医院）麻醉科 | 13976674619@163.com |
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| 中文摘要: |
| 随着加速术后康复（ERAS）理念的推广，多模式镇痛策略逐渐成为术后疼痛管理的核心方向。艾司氯胺酮作为一种高选择性N-甲基-D-天冬氨酸（NMDA）受体拮抗药，因其具有快速起效、呼吸抑制轻微、阿片类药物节约效应等独特的药理特性，在多模式镇痛中的应用备受关注。现有研究表明，艾司氯胺酮可有效降低急慢性疼痛强度，减少阿片类药物用量及术后并发症，但其最佳剂量、给药途径及长期安全性仍需进一步探索。本文系统综述艾司氯胺酮的作用机制、药理特性以及在多模式镇痛中的应用进展，以期为其在临床中的规范化应用提供参考。 |
| 英文摘要: |
| With the widespread adoption of the enhanced recovery after surgery (ERAS) concept, multimodal analgesia strategies have gradually become the cornerstone of postoperative pain management. Esketamine, as a highly selective N-methyl-D-aspartate (NMDA) receptor antagonist, has garnered significant attention for its application within multimodal analgesic regimens due to its unique pharmacological properties, such as rapid onset of action, minimal respiratory depression, and opioid-sparing effects. Current researches indicate that esketamine effectively reduces acute and chronic pain intensity, decreases opioid consumption, and lowers the incidence of postoperative complications. However, further research is required to establish its optimal dosage, preferred routes of administration, and long-term safety profile. This article conducts a systematic review of the mechanism of action, pharmacological characteristics, and recent advances in the clinical application of esketamine in multimodal analgesia, aiming to provide insights for its standardized implementation in clinical practice． |
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