Article(id=1292126377155784854, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.04.008, 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=1785996534861, onlineDateStr=2026-08-06, pubDate=1772208000000, pubDateStr=2026-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785996534861, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785996534861, creator=13701087609, updateTime=1785996534861, updator=13701087609, issue=Issue{id=1292126355785802497, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='4', pageStart='451', pageEnd='600', issueExtLink='null', onlineDate='null', pubDate='1772208000000', pubDateStr='2026-02-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785996529766, creator='13701087609', updateTime=1786014519902, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201811952292026, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201811952292027, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126355785802497, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=500, endPage=506, ext={EN=ArticleExt(id=1292126377382277271, articleId=1292126377155784854, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of effects of sub-anesthetic dose esketamine combined with subcostal transversus abdominis plane block on postoperative delirium in patients undergoing radical resection of colorectal cancer, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the effect and safety of subanesthetic-dose esketamine combined with subcostal transversus abdominis plane block (STAPB) on postoperative delirium in patients undergoing radical resection for colorectal cancer (CRC).
Methods Patients scheduled for radical CRC resection were divided into control group and treatment group according to the anesthetic regimen. The control group received conventional anesthesia, while the treatment group was intravenously administered 0.2 mg·kg-1 esketamine hydrochloride injection before endotracheal intubation on the basis of the conventional anesthesia protocol. Both groups underwent STAPB after intubation and before skin incision. The excellent and good rate of anesthesia, surgical parameters, hemodynamic indices, postoperative recovery quality-related indicators, incidence of delirium, analgesic efficacy parameters, and adverse reactions were compared between the two groups.
Results A total of 52 patients were enrolled in the control group and 48 in the treatment group. The excellent/good rates of anesthesia of treatment group and control group were 91.67% (44 cases/48 cases) and 88.46% (46 cases/52 cases), respectively (P>0.05). The fluid infusion volume of treatment group and control group were (1 412.69±38.27) and (1 428.63±35.47) mL, respectively; the heart rates at T3 were (76.19±8.56) and (80.69±9.14)beats·min-1, respectively; systolic blood pressure at T3 were (131.08±10.39) and (138.52±13.78) mmHg, respectively; diastolic blood pressure at T3 were (79.94±7.27) and (82.35±8.25) mmHg, respectively; the extubation time were (16.75±2.71) and (15.54±2.42) min, respectively; the recovery time were (18.63±2.81) and (20.40±2.86) min, respectively; the Quality of Recovery-40 (QoR-40) scores on postoperative day 2 were (160.79±18.70) and (154.35±20.56) points, respectively; the lower Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) on postoperative day 7 were (6.25±1.76) and (7.10±2.05) points, respectively; the Depression subscale (HADS-D) on postoperative day were (6.13±1.82) and (7.15±1.95) points, respectively; the total incidences of delirium were 10.42% (5 cases/48 cases) and 26.92% (14 cases/52 cases), respectively; the Numerical Rating Scale (NRS) scores for resting pain were (2.00±0.41) and (2.17±0.47), respectively; the dynamic pain at 48 h postoperatively were 2.60±0.54 and 2.81±0.60), respectively; the differences of above indicators between two groups were all statistically significant (P<0.05, P<0.01, P<0.001). The main adverse drug reactions included dizziness, tachycardia, bucking, nausea and vomiting in the control group, and dizziness, tachycardia, hypertension, nausea and vomiting in the treatment group. The total incidence of adverse drug reactions was 9.62% (6 cases/52 cases) in the control group and 12.50% (6 cases/48 cases) in the treatment group, with no statistically significant difference (P>0.05).
Conclusion Subanesthetic-dose esketamine combined with STAPB for patients undergoing radical CRC resection can reduce intraoperative fluid requirements, stabilize perioperative blood pressure and heart rate fluctuations, improve postoperative recovery quality, alleviate postoperative anxiety and depression, and decrease the incidence of postoperative delirium. This combined regimen also yields definite postoperative analgesic effects and does not increase the risk of adverse reactions, thus exhibiting favorable clinical safety and tolerability.
, authors=Liu-ping WU
a, Cheng CHEN
a, Wan-yu ZHOU
a, Hu-yun XIE
a, Yu-ran ZHOU
a, Jia-wei YU
b, authorsList=Liu-ping WU, Cheng CHEN, Wan-yu ZHOU, Hu-yun XIE, Yu-ran ZHOU, Jia-wei YU, authorCompany=null, correspAuthors=Liu-ping WU, 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=1292126377642324120, articleId=1292126377155784854, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=亚麻醉剂量艾司氯胺酮联合腹横肌平面阻滞对结直肠癌根治术患者术后谵妄影响的临床研究, 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 观察亚麻醉剂量艾司氯胺酮注射液联合腹横肌平面阻滞（STAPB）对结直肠癌（CRC）根治术患者术后谵妄的影响和安全性。
方法 将CRC患者根据是否联合用药分为对照组和试验组。对照组给予常规麻醉。试验组插管前在对照组基础上使用盐酸艾司氯胺酮注射液0.2 mg·kg-1单次静脉注射。在插管后，手术切皮前2组均给予STAPB。比较2组麻醉优良率、手术一般情况、血流动力学指标、苏醒质量相关指标、谵妄发生情况和镇痛效果指标并进行安全性评价。
结果 对照组纳入52例，试验组纳入48例。试验组和对照组麻醉优良率在分别为91.67%（44例/48例）和88.46%（46例/52例）（P>0.05）。试验组和对照组输液量分别为（1 412.69±38.27）和（1 428.63±35.47）mL，T3心率分别为每分钟（76.19±8.56）和（80.69±9.14）次，T3收缩压分别为（131.08±10.39）和（138.52±13.78）mmHg，T3舒张压分别为（79.94±7.27）和（82.35±8.25）mmHg，拔管时间分别为（16.75±2.71）和（15.54±2.42）min，苏醒时间分别为（18.63±2.81）和（20.40±2.86）min，术后2 d 40项恢复质量量表评分分别为（160.79±18.70）和（154.35±20.56）分，术后7 d医院焦虑-抑郁量表-焦虑子量表评分分别为（6.25±1.76）和（7.10±2.05）分，术后7 d医院焦虑-抑郁量表-抑郁子量表评分分别为（6.13±1.82）和（7.15±1.95）分，谵妄总发生率分别为10.42%（5例/48例）和26.92%（14例/52例），术后48 h静息时疼痛数字分级评分法（NRS）评分分别为（2.00±0.41）和（2.17±0.47）分，术后48 h活动时NRS评分分别为（2.60±0.54）和（2.81±0.60）分，上述指标2组间比较，在统计学上差异均有统计学意义（P<0.05，P<0.01，P<0.001）。试验组的药物不良反应主要有头晕、心动过速、高血压、恶心呕吐。对照组的药物不良反应主要有头晕、心动过速、呛咳、恶心呕吐，对照组和试验组总药物不良反应发生率分别为9.62%（6例/52例）和12.50%（6例/48例），在统计学上差异无统计学意义（P>0.05）。
结论 亚麻醉剂量艾司氯胺酮联合STAPB应用于CRC根治术患者，可减少术中液体输注量，稳定血压和HR波动，提升术后苏醒质量，减轻术后焦虑抑郁情绪，降低术后谵妄发生率，同时该联合方案术后镇痛效果确切，且未增加不良反应发生率，具有良好的临床安全性。
, authors=吴刘萍
a, 陈诚
a, 周婉玉
a, 解胡运
a, 周裕然
a, 于嘉伟
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吴刘萍（1979-），女，副主任医师，主要从事围术期器官保护方面的工作研究
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