Article(id=1291706976187212673, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291706966187991876, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.24.002, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758470400000, receivedDateStr=2025-09-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896541878, onlineDateStr=2026-08-05, pubDate=1766851200000, pubDateStr=2025-12-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896541878, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896541878, creator=13701087609, updateTime=1785896541878, updator=13701087609, issue=Issue{id=1291706966187991876, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='24', pageStart='3451', pageEnd='3600', issueExtLink='null', onlineDate='null', pubDate='1766851200000', pubDateStr='2025-12-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896539494, creator='13701087609', updateTime=1785998798662, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292135872292479273, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291706966187991876, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292135872296673578, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291706966187991876, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3458, endPage=3464, ext={EN=ArticleExt(id=1291706978200478594, articleId=1291706976187212673, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of subanesthetic dose of esketamine and quadratus lumborum block for radical resection of colorectal cancer in elderly patients, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of subanesthetic dose of esketamine injection and quadratus lumborum block in elderly patients undergoing radical resection of colorectal cancer.
Methods Patients undergoing radical resection of colorectal cancer were divided into treatment group and control group according to the anesthesia method. Both groups underwent bilateral quadratus lumborum block under ultrasound guidance. Anesthesia induction was performed with etomidate injection at a dose of 0.1-0.3 mg·kg-1, sufentanil injection at a dose of 0.3-0.6 μg·kg-1, midazolam injection at a dose of 0.04-0.06 mg·kg-1, and cisatracurium injection at a dose of 0.2 mg·kg-1. Anesthesia was maintained with propofol injectation emulasion 4-8 mg·kg-1·h-1, remifentanil for injection 0.15-0.3 μg·kg-1·min-1, and dexmedetomidine injection 0.2-1.0 μg·kg-1·h-1. The treatment group received a single intravenous injection of 0.25 mg·kg-1 esketamine injection 5 min before surgery, while the control group received routine anesthesia management without esketamine injection intervention. Both groups received intravenous patient-controlled analgesia postoperatively. Hemodynamics, analgesia and sedation, postoperative opioid consumption, and recovery quality were compared between the two groups, and safety was evaluated.
Results A total of 108 patients were enrolled, the treatment group included 52 cases and the control group included 56 cases. The mean arterial pressure (MAP) at T3 in the treatment and control groups were (86.04±6.43) and (83.20±6.80) mmHg, respectively; the heart rate (HR) at T3 were (76.21±5.56) and (73.96±5.31) beats·min-1, respectively; the numerical rating scale (NRS) at 12 h postoperatively were (2.04±0.77) and (2.29±0.65) points, respectively; sufentanil consumption were (88.63±11.28) and (94.30±12.22) μg, respectively; the effective pressing times of the analgesia pump within 24 h postoperatively were (5.65±1.17) and (6.23±1.40) times, respectively, and the effective pressing times of the analgesia pump within 24-48 h postoperatively were (7.06±1.51) and (7.89±2.18) times, respectively; the awakening time were (21.25±4.58) and (23.68±4.87) min, respectively, and the length of stay in the postanesthesia care unit (PACU) were (36.23±6.91) and (40.05±7.42) min, respectively. The differences were all statistically significant (P<0.05, P<0.01). The adverse drug reactions in the treatment group were dizziness, nausea and vomiting, while the adverse drug reaction in the control group was skin pruritus. The total incidence of adverse reactions in the treatment and control groups was 3.85% (2 cases/52 cases) and 1.79% (1 case/56 cases), respectively, and the difference was not statistically significant (P>0.05).
Conclusion The application of subanesthetic dose of esketamine and quadratus lumborum block in elderly patients undergoing radical resection of colorectal cancer can effectively reduce postoperative opioid consumption, provide good sedation and analgesia, maintain hemodynamic stability, protect lung function, and improve recovery quality. It has little impact on cognitive function and sleep quality, and has good safety.
, authors=Er-song WANG
1, Hai-yan LI
2, Ning YANG
2, Chao LI
2, Jing YANG
2, authorsList=Er-song WANG, Hai-yan LI, Ning YANG, Chao LI, Jing YANG, authorCompany=null, correspAuthors=Er-song WANG, 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=1291706978657657731, articleId=1291706976187212673, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=亚麻醉剂量艾司氯胺酮联合腰方肌阻滞用于老年结直肠癌手术的临床研究, 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 观察老年结直肠癌根治术患者应用亚麻醉剂量艾司氯胺酮注射液联合腰方肌神经阻滞的临床疗效及安全性。
方法 将结直肠癌根治术患者按麻醉方法分为试验组和对照组。2组患者均在超声引导下行双侧腰方肌神经阻滞，依托咪酯注射液0.1~0.3 mg·kg-1、舒芬太尼注射液0.3~0.6 μg·kg-1、咪达唑仑注射液0.04~0.06 mg·kg-1、顺式阿曲库铵注射液0.2 mg·kg-1进行麻醉诱导，用丙泊酚乳状注射液4~8 mg·kg-1·h-1、注射用瑞芬太尼0.15~0.3 μg·kg-1·min-1、右美托咪定注射液0.2~1.0 μg·kg-1·h-1进行麻醉维持，试验组术前5 min给予单次静脉注射0.25 mg·kg-1艾司氯胺酮注射液，对照组常规麻醉管理不进行艾司氯胺酮干预，术后均行静脉自控镇痛。比较2组患者的血流动力学、镇痛镇静、术后阿片类药物用量和恢复质量，并进行安全性评价。
结果 本研究共纳入患者108例，试验组入组52例，对照组入组56例。试验组、对照组T3时平均动脉压（MAP）水平分别为（86.04±6.43）和（83.20±6.80）mmHg，T3时心率（HR）水平分别为（76.21±5.56）和（73.96±5.31）beats·min-1，术后12 h的疼痛评分（NRS）分别为（2.04±0.77）和（2.29±0.65）分；舒芬太尼用量分别为（88.63±11.28）和（94.30±12.22）μg，术后24 h镇痛泵有效按压次数分别为（5.65±1.17）和（6.23±1.40）次，术后24~48 h镇痛泵有效按压次数分别为（7.06±1.51）和（7.89±2.18）次，苏醒时间分别为（21.25±4.58）和（23.68±4.87）min，麻醉后监测治疗室（PACU）停留时间分别为（36.23±6.91）和（40.05±7.42）min，试验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（P<0.05，P<0.01）。试验组的药物不良反应为头晕、恶心呕吐，对照组为皮肤瘙痒，试验组、对照组药物不良反应总发生率分别为3.85%（2例/52例）和1.79%（1例/56例），在统计学上差异无统计学意义（P>0.05）。
结论 老年结直肠癌根治术应用亚麻醉剂量艾司氯胺酮联合腰方肌神经阻滞，能够有效减少术后阿片类药物用量，提供较好的镇静、镇痛效果，维持血流动力学稳定，保护肺功能，提高恢复质量，对认知功能、睡眠质量的影响较小，并且安全性较好。
, authors=王二松
1, 李海燕
2, 杨宁
2, 李超
2, 杨静
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王二松（1986-），男，主治医师，主要从事危重症老年患者手术麻醉管理方面的临床工作和研究
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王二松（1986-），男，主治医师，主要从事危重症老年患者手术麻醉管理方面的临床工作和研究
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王二松（1986-），男，主治医师，主要从事危重症老年患者手术麻醉管理方面的临床工作和研究
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