Article(id=1291404415420846975, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404401374130524, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.05.007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729699200000, receivedDateStr=2024-10-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785824405770, onlineDateStr=2026-08-04, pubDate=1742140800000, pubDateStr=2025-03-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785824405770, onlineIssueDateStr=2026-08-04, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785824405770, creator=13701087609, updateTime=1785824405770, updator=13701087609, issue=Issue{id=1291404401374130524, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='5', pageStart='601', pageEnd='750', issueExtLink='null', onlineDate='null', pubDate='1742140800000', pubDateStr='2025-03-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785824402421, creator='13701087609', updateTime=1785897165150, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291709590438170760, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404401374130524, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291709590438170761, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404401374130524, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=631, endPage=635, ext={EN=ArticleExt(id=1291404415844471680, articleId=1291404415420846975, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of propofol combined with esketamine in the treatment of elderly patients after lower limb arthroplasty, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the influence of propofol injection emulsion combined with esketamine injection on hemodynamics and postoperative recovery quality in elderly patients after lower limb arthroplasty.
Methods The elderly patients undergoing lower limb joint replacement were divided into low-dose group (0.25 mg·kg-1 esketamine), high-dose group (0.50 mg·kg-1 esketamine) and control group (equal volume of 0.9% NaCl) according to the cohort method. Hemodynamics [heart rate (HR), mean arterial pressure (MAP)], postoperative recovery quality scale-15 (QoR-15) scores, dosages of anesthetic drugs, Ramsay sedation score, recovery quality and adverse reactions were compared among the three groups.
Results In this study, 39 cases were enrolled in the low-dose group, 40 cases in the high-dose group and 42 cases in the control group. The HR of patients in low-dose group, high-dose group and control group immediately after operation (T1) was (76.39±5.77), (77.16±5.24) and (73.21±4.79) beat·min-1, respectively; MAP values were (85.11±5.22), (85.21±5.37) and (82.79±4.86) mmHg, respectively; at 15 min after operation, the HR of T2 were (78.36±5.11), (78.24±5.02) and (80.67±4.57) beat·min-1; the MAP were (85.75±5.11), (85.39±4.97) and (87.93±3.67) mmHg, respectively; the QoR-15 scores 24 h after operation were (108.19±10.29), (109.56±10.12) and (99.66±10.21) points, respectively; the dosage of propofol were (220.66±25.19), (211.66±27.88) and (283.37±26.28) mg, respectively; the dosage of remifentanil were (2.37±0.42), (2.24±0.38) and (2.89±0.35) mg, respectively; Ramsay sedation scores were (1.56±0.27), (1.61±0.22) and (1.58±0.24) points at T0; and (3.18±0.33), (3.29±0.34) and (2.67±0.29) points at T3, respectively. Compared with the control group, there were statistically significant differences in the above indexes between the low-dose group and the high-dose group (all P<0.05), while there were no statistically significant differences in the above indexes between the low-dose group and the high-dose group (all P>0.05). Adverse drug reactions included respiratory depression, nausea/vomiting, dizziness, restlessness, hypotension, etc. The total incidence of adverse drug reactions were 2.56% (1 case /39 cases) in the low-dose group, 15.00% (6 cases/40 cases) in the high-dose group, and 26.19% (11 cases /42 cases) in the control group. The total incidence of adverse drug reactions of low-dose group was significantly lower than the control group, and the difference was statistically significant (P<0.05).
Conclusion The application of propofol combined with esketamine can reduce the intraoperative dosages of propofol and remifentanil in elderly patients undergoing knee arthroplasty, enhance the sedation effect, improve the hemodynamics, and promote the postoperative recovery.
, authors=Wei ZHAO, Xue-min HAN, Shi-yao SUI, Xiu-ting MEN, authorsList=Wei ZHAO, Xue-min HAN, Shi-yao SUI, Xiu-ting MEN, authorCompany=null, correspAuthors=Xue-min HAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291404416746247041, articleId=1291404415420846975, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=丙泊酚联合艾司氯胺酮用于下肢关节置换术老年患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察丙泊酚乳状注射液联合艾司氯胺酮注射液对老年下肢关节置换术后血流动力学和术后恢复质量的影响。
方法 将行下肢关节置换术的老年患者按照队列法分为低剂量组（0.25 mg·kg-1艾司氯胺酮）、高剂量组（0.50 mg·kg-1艾司氯胺酮）和对照组（等体积的0.9% NaCl）。比较3组患者的血流动力学[心率（HR）、平均动脉压（MAP）]、术后15项恢复质量量表（QoR-15）评分、麻醉药物使用剂量、Ramsay镇静评分、苏醒质量，并进行安全性评价。
结果 低剂量组入组39例，高剂量组入组40例，对照组入组42例。低剂量组、高剂量组和对照组患者手术开始即刻（T1）的HR分别为（76.39±5.77）、（77.16±5.24）和（73.21±4.79）beat·min-1，MAP分别为（85.11±5.22）、（85.21±5.37）和（82.79±4.86）mmHg；手术开始后15 min时（T2）的HR分别为（78.36±5.11）、（78.24±5.02）和（80.67±4.57）beat·min-1，MAP分别为（85.75±5.11）、（85.39±4.97）和（87.93±3.67）mmHg，术后24 h的QoR-15评分分别为（108.19±10.29）、（109.56±10.12）和（99.66±10.21）分，丙泊酚用量分别为（220.66±25.19）、（211.66±27.88）和（283.37±26.28）mg，瑞芬太尼的用量分别为（2.37±0.42）、（2.24±0.38）和（2.89±0.35）mg，T0时的Ramsay镇静评分分别为（1.56±0.27）、（1.61±0.22）和（1.58±0.24）分，T3时的Ramsay镇静评分分别为（3.18±0.33）、（3.29±0.34）和（2.67±0.29）分，低剂量组和高剂量组的上述指标与对照组比较，在统计学上差异均有统计学意义（均P<0.05），低剂量组上述指标与高剂量组比较，在统计学上差异均无统计学意义（均P>0.05）。药物不良反应包括呼吸抑制、恶心/呕吐、头晕、躁动、低血压等，低剂量组药物不良反应总发生率为2.56%（1例/39例），高剂量组药物不良反应总发生率为15.00%（6例/40例），对照组药物不良反应总发生率为26.19%（11例/42例），低剂量组的药物不良反应总发生率明显低于对照组，在统计学上差异有统计学意义（P<0.05）。
结论 丙泊酚乳状注射液联合艾司氯胺酮注射液应用可减少老年膝关节置换术患者术中丙泊酚、瑞芬太尼的使用量，提高镇静效果，改善血流动力学，促进术后恢复。
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赵伟（1984-），男，副主任医师，主要从事老年骨科手术麻醉方面工作或研究
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