中国临床药理学杂志

右美托咪定复合艾司氯胺酮用于口腔鳞状细胞癌根治术患者的临床研究

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陈建兴 ^1a^,^1b^,² , 林文谦 ^1a^,^1b^,² , 吴雅君 ^1a^,^1b^,² , 陈志建 ³

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(2): 188-192

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (2) : 188 -192

右美托咪定复合艾司氯胺酮用于口腔鳞状细胞癌根治术患者的临床研究

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陈建兴^1a^,^1b^,², 林文谦^1a^,^1b^,², 吴雅君^1a^,^1b^,², 陈志建³

作者信息

^1a.福建医科大学附属第一医院，麻醉科，福建福州 350005

^1b.福建医科大学附属第一医院，滨海院区国家区域医疗中心麻醉科，福建福州 350005

^2.福建医科大学麻醉学研究所，福建福州 350005

^3.厦门大学附属第一医院杏林院区麻醉科，福建厦门 361000

通讯作者:

陈志建，副主任医师 MP: 15960808878 E-mail: 81573964@qq.com

作者简介:

陈建兴（1990-），男，硕士研究生，主治医师，主要从事麻醉学方向的相关研究

Clinical trial of dexmedetomidine combined with esketamine in the treatment of patients with oral squamous cell carcinoma radical resection

Jian-xing CHEN^1a^,^1b^,², Wen-qian LIN^1a^,^1b^,², Ya-jun WU^1a^,^1b^,², Zhi-jian CHEN³

Affiliations

^1a.Department of Anesthesiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China

^1b.Department of Anesthesiology, National Regional Medical Center, Binhai Campus, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China

^2.Anesthesiology Research Institute, Fujian Medical University, Fuzhou 350005, Fujian Province, China

^3.Department of Anesthesiology, Xinglin Hospital, The First Affiliated Hospital of Xiamen University, Xiamen 361000, Fujian Province, China

出版时间: 2025-01-28 doi: 10.13699/j.cnki.1001-6821.2025.02.008

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摘要

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目的

观察右美托咪定注射液复合艾司氯胺酮注射液用于口腔鳞状细胞癌根治术患者的临床疗效及安全性。

方法

将拟行口腔鳞状细胞癌根治术患者随机分为试验组和对照组。试验组于麻醉诱导前10 min静脉注射0.6 μg·kg^-1右美托咪定，然后静脉注射0.5 mg·kg^-1艾司氯胺酮进行麻醉诱导，静脉泵注0.25 mg·kg^-1·h^-1艾司氯胺酮+0.3 μg·kg^-1·h^-1右美托咪定进行麻醉维持。对照组于麻醉诱导前10 min静脉注射等体积0.9% NaCl，然后静脉注射2.5~5.0 μg·kg^-1芬太尼进行麻醉诱导，静脉泵注0.10~0.25 μg·kg^-1·min^-1瑞芬太尼定进行麻醉维持。比较2组患者的麻醉效果、镇痛效果、血流动力学，以及安全性。

结果

试验组入组62例，脱落1例，最终有61例纳入统计学分析；对照组入组61例，脱落1例，最终有60例纳入统计学分析。试验组和对照组的麻醉后恢复室停留时间分别为（25.97±4.52）和（18.39±3.64）min，拔管时间分别为（16.75±4.84）和（10.16±3.18）min，在统计学上差异均有统计学意义（均P<0.05）。术后24 h，试验组和对照组的视觉模拟评分分别为（0.85±0.17）和（1.39±0.25）分，促肾上腺皮质激素水平分别为（60.07±7.13）和（72.64±9.81）pg·mL^-1，皮质醇水平分别为（481.20±49.15）和（539.94±57.77）nmol·L^-1，在统计学上差异均有统计学意义（均P<0.05）。试验组麻醉诱导后30 min（T1）、手术结束（T2）时的平均动脉压分别为（82.34±4.98）和（86.57±4.18）mmHg，对照组分别为（77.25±7.16）和（76.02±6.29）mmHg，试验组T1、T2时的心率分别为（64.08±4.19）和（66.45±4.83）time·min^-1，对照组分别为（68.44±6.02）和（72.08±7.27）time·min^-1，在统计学上差异均有统计学意义（均P<0.05）。2组患者的药物不良反应均以恶心呕吐、心动过缓、头晕等为主。试验组和对照组的总药物不良反应发生率分别为8.20%和15.00%，在统计学上差异无统计学意义（P>0.05）。

结论

右美托咪定注射液复合艾司氯胺酮注射液用于口腔鳞状细胞癌根治术患者的镇痛效果确切，其能够显著减轻患者的应激反应，维持血流动力学稳定，且不增加药物不良反应的发生率。

关键词

右美托咪定注射液 / 艾司氯胺酮注射液 / 口腔鳞状细胞癌 / 安全性评价

Abstract

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Objective

To observe the clinical efficacy and safety of dexmedetomidine injection combined with esketamine injection in the treatment of patients with oral squamous cell carcinoma radical resection.

Methods

Patients with oral squamous cell carcinoma radical resection were randomly divided into treatment and control groups. The treatment group will receive intravenous administration of 0.6 μg·kg^-1 dexmedetomidine 10 minutes before anesthesia induction. Subsequently, anesthesia induction will be performed with intravenous administration of 0.5 mg·kg^-1 esketamine. Anesthesia maintenance will be achieved with intravenous infusion of 0.25 mg·kg^-1·h^-1 esketamine and 0.3 μg·kg^-1·h^-1 dexmedetomidine used an infusion pump. The control group will receive intravenous administration of an equivalent volume of 0.9% NaCl 10 minutes before anesthesia induction. Anesthesia induction will then be performed with intravenous administration of 2.5-5.0 μg·kg^-1 fentanyl. Anesthesia maintenance will involve intravenous infusion of 0.10-0.25 μg·kg^-1·min^-1 remifentanil used an infusion pump. The anesthesia effectiveness, analgesic effectiveness, hemodynamics and safety were compared between the two groups.

Results

Treatment group were enrolled 62 cases, 1 case dropped out, and 61 cases were finally included in the statistical analysis. Control group were enrolled 61 cases, 1 case dropped out, and 60 cases were finally included in the statistical analysis. The recovery room stay time of treatment and control groups was (25.97±4.52) and (18.39±3.64) min, the extubation time was (16.75±4.84) and (10.16±3.18) min, and the differences were statistically significant (all P<0.05). After operation 24 h, visual analogue scores of treatment and control groups were (0.85±0.17) and (1.39±0.25) points, adrenocorticotropin levels were (60.07±7.13) and (72.64±9.81) pg·mL^-1, cortisol levels were (481.20±49.15) and (539.94±57.77) nmol·L^-1, and the differences were statistically significant (all P<0.05). The mean arterial pressure at 30 min after anesthesia induction (T1) and at the end of surgery (T2) in treatment group were (82.34±4.98) and (86.57±4.18) mmHg, while those in control group were (77.25±7.16) and (76.02±6.29) mmHg; the heart rates of T1 and T2 in treatment groups were (64.08±4.19) and (66.45±4.83) time·min^-1, while those in control group were (68.44±6.02) and (72.08±7.27) time·min^-1; and the differences were statistically significant (all P<0.05). The adverse drug reactions in two groups were nausea, vomiting, bradycardia and dizziness. The total incidences of adverse drug reactions in treatment and control groups were 8.20% and 15.00%, without significant difference (P>0.05).

Conclusion

Dexmedetomidine injection combined with esketamine injection has a definitive analgesia efficacy in the treatment of patients with oral squamous cell carcinoma radical resection, which can significantly reduce stress responses, maintain hemodynamic stability, without increasing the incidence of adverse drug reactions.

Key words

dexmedetomidine injection / esketamine injection / oral squamous cell carcinoma / safety evaluation

引用本文

陈建兴, 林文谦, 吴雅君, 陈志建. 右美托咪定复合艾司氯胺酮用于口腔鳞状细胞癌根治术患者的临床研究. 中国临床药理学杂志, 2025 , 41 (2) : 188 -192 . DOI: 10.13699/j.cnki.1001-6821.2025.02.008

Jian-xing CHEN, Wen-qian LIN, Ya-jun WU, Zhi-jian CHEN. Clinical trial of dexmedetomidine combined with esketamine in the treatment of patients with oral squamous cell carcinoma radical resection[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (2) : 188 -192 . DOI: 10.13699/j.cnki.1001-6821.2025.02.008

基金

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福建省自然科学基金资助项目(2022J011369)

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2025年第41卷第2期

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doi: 10.13699/j.cnki.1001-6821.2025.02.008

接收时间：2024-07-24
首发时间：2026-08-04
出版时间：2025-01-28

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收稿日期：2024-07-24

基金

福建省自然科学基金资助项目(2022J011369)

作者信息

^1a.福建医科大学附属第一医院，麻醉科，福建福州 350005

^1b.福建医科大学附属第一医院，滨海院区国家区域医疗中心麻醉科，福建福州 350005

^2.福建医科大学麻醉学研究所，福建福州 350005

^3.厦门大学附属第一医院杏林院区麻醉科，福建厦门 361000

通讯作者:

陈志建，副主任医师 MP: 15960808878 E-mail: 81573964@qq.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.02.008

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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