中国临床药理学杂志

艾司氯胺酮复合瑞马唑仑应用于前列腺癌根治术对麻醉效果的影响

PDF下载

邱靖 ^1a , 唐智豪 ^1a , 蔡振 ^1a , 周鹏飞 ^1b

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(4): 472-476

收起

中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (4) : 472 -476

艾司氯胺酮复合瑞马唑仑应用于前列腺癌根治术对麻醉效果的影响

全屏

邱靖^1a, 唐智豪^1a, 蔡振^1a, 周鹏飞^1b

作者信息

^1a.浙江大学医学院附属金华医院/金华市中心医院，麻醉科，浙江金华 321000

^1b.浙江大学医学院附属金华医院/金华市中心医院，泌尿科，浙江金华 321000

通讯作者:

唐智豪，副主任医师 MP: 13757981567 E-mail: tzhao1226@163.com

作者简介:

邱靖（1986-），男，主治医师，主要从事肺保护性通气和术中循环管理方面的工作

Effect of esketamine combined with remimazolam on anesthetic effect in radical prostatectomy for prostate cancer

Jing QIU^1a, Zhi-hao TANG^1a, Zhen CAI^1a, Peng-fei ZHOU^1b

Affiliations

^1a.Department of Anesthesiology, Jinhua Central Hospital, School of Medicine, Zhejiang University, Jinhua 321000, Zhejiang Province, China

^1b.Department of Urology, Jinhua Central Hospital, School of Medicine, Zhejiang University, Jinhua 321000, Zhejiang Province, China

出版时间: 2025-02-28 doi: 10.13699/j.cnki.1001-6821.2025.04.005

文章导航

摘要

收起

目的

观察艾司氯胺酮注射液复合瑞马唑仑注射液在前列腺癌根治术中的麻醉效果及安全性。

方法

将进行前列腺癌根治术的患者按照队列法分为对照组和试验组，对照组用0.2 mg·kg^-1瑞马唑仑注射液复合1 mg·kg^-1丙泊酚注射液实施麻醉诱导，试验组用0.5 mg·kg^-1艾司氯胺酮注射液复合0.1 mg·kg^-1瑞马唑仑注射液实施麻醉诱导，2组患者均用4~8 mg·kg^-1·h^-1丙泊酚注射液复合5~10 μg·kg^-1·h^-1瑞芬太尼注射液进行麻醉维持。比较2组患者的镇痛效果、镇静效果、血流动力学[麻醉前（T0）、气管插管（T1）、术中30 min（T2）、术后2 h（T3）]、机体应激（T0~T3）及安全性。

结果

对照组和试验组各入组44例和42例。试验组术后3、6、12和24 h的数字疼痛评定量表（NRS）评分分别为（2.71±0.46）、（2.52±0.43）、（2.24±0.32）和（2.25±0.29）分，静脉自控镇痛（PCIA）用药剂量为（52.38±6.67）mL，对照组术后3、6、12和24 h的NRS评分分别为（3.49±0.52）、（3.27±0.44）、（2.73±0.41）和（2.54±0.39）分，PCIA用药剂量为（64.79±7.45）mL；试验组T1、T2、T3时心率（HR）分别为（105.48±3.34）、（102.67±3.45）和（100.29±1.93）beat·min^-1，T1、T2时血清皮质醇（Cor）分别为（257.68±29.18）和（303.75±31.52）nmoL·L^-1，T2、T3时血清超氧化物歧化酶（SOD）分别为（425.85±50.45）和（422.96±50.21）U·L^-1；对照组T1、T2、T3时HR分别为（95.38±2.26）、（91.52±2.68）和（87.15±1.40）beat·min^-1，T1、T2时血清Cor分别为（307.36±32.11）和（322.38±33.45）nmoL·L^-1，T2、T3时血清SOD分别为（401.23±46.21）和（388.24±45.87）U·L^-1。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主要有苏醒躁动、恶心呕吐，对照组的药物不良反应主要有复视、苏醒躁动、恶心呕吐。试验组和对照组的药物不良反应总发生率分别为13.64%（6例/44例）和16.67%（7例/42例），在统计学上差异无统计学意义（P>0.05）。

结论

艾司氯胺酮注射液复合瑞马唑仑注射液对前列腺癌根治术患者麻醉效果良好，可以有效减轻术后疼痛和机体生理应激，利于术后早期功能恢复，安全性较好。

关键词

艾司氯胺酮注射液 / 瑞马唑仑注射液 / 前列腺癌根治术 / 镇痛 / 机体应激 / 麻醉复苏 / 功能恢复

Abstract

收起

Objective

To observe the anesthetic effect of esketamine injection combined with remimazolam injection in radical prostatectomy for prostate cancer.

Methods

The patients were divided into the control group and the treatment group according to cohort method. The control group was given anesthesia induction with remimazolam injection at 0.2 mg·kg^-1 combined with propofol injection at 1 mg·kg^-1. The treatment group was given anesthesia induction with esketamine injection at 0.5 mg·kg^-1 combined with remimazolam injection at 0.1 mg·kg^-1. Both groups underwent maintenance of anesthesia with propofol injection at 4-8 mg·kg^-1·h^-1 combined with remifentanil injection at 5-10 μg·kg^-1·h^-1. The analgesic effect, sedative effect, hemodynamics [before anesthesia (T0), tracheal intubation (T1), 30 min after the beginning of surgery (T2), 2 h after surgery (T3)], stress (T0~T3) and safety were compared between the two groups.

Results

The control group and the treatment group were enrolled in 44 cases and 42 cases, respectively. At 3 h, 6 h, 12 h and 24 h after surgery, the Numerical Rating Scale (NRS) scores of the treatment groups were 2.71±0.46, 2.52±0.43, 2.24±0.32 and 2.25±0.29; the dosage of patient-controlled intravenous analgesia (PCIA) was (52.38±6.67) mL. At 3 h, 6 h, 12 h and 24 h after surgery, NRS scores of the control group were 3.49±0.52, 3.27±0.44, 2.73±0.41 and 2.54±0.39; the dosage of PCIA was (64.79±7.45) mL. For the treatment group, heart rate (HR) were (105.48±3.34), (102.67±3.45) and (100.29±1.93) beat·min^-1 from T1, T2, T3; serum cortisol (Cor) levels at T1 and T2 were (257.68±29.18) and (303.75±31.52) nmoL·L^-1; serum superoxide dismutase (SOD) levels at T2 and T3 were (425.85±50.45) and (422.96±50.21) U·L^-1. For the control group, HR were (95.38±2.26), (91.52±2.68) and (87.15±1.40) beats·min^-1 from T1, T2, T3; serum Cor levels at T1 and T2 were (307.36±32.11) and (322.38±33.45) nmoL·L^-1; serum SOD levels at T2 and T3 were (401.23±46.21) and (388.24±45.87) U·L^-1. The differences were statistically significant (all P<0.05). Adverse drug reactions in the treatment group mainly included emergence agitation, nausea and vomiting. Adverse drug reactions in the control group mainly included diplopia, emergence agitation, nausea and vomiting. The total incidence rates of adverse drug reactions in the treatment group and the control group were 13.64% (6 cases/44 cases) and 16.67% (7 cases /42 cases), without statistically significant difference (P>0.05).

Conclusion

Esketamine injection combined with remimazolam injection can achieve good anesthetic effect on patients undergoing radical prostatectomy for prostate cancer, which can effectively alleviate postoperative pain and physiological stress, and facilitate postoperative early functional recovery, with good safety.

Key words

esketamine injection / remimazolam injection / radical prostatectomy for prostate cancer / analgesia / stress / anesthesia recovery / functional recovery

引用本文

邱靖, 唐智豪, 蔡振, 周鹏飞. 艾司氯胺酮复合瑞马唑仑应用于前列腺癌根治术对麻醉效果的影响. 中国临床药理学杂志, 2025 , 41 (4) : 472 -476 . DOI: 10.13699/j.cnki.1001-6821.2025.04.005

Jing QIU, Zhi-hao TANG, Zhen CAI, Peng-fei ZHOU. Effect of esketamine combined with remimazolam on anesthetic effect in radical prostatectomy for prostate cancer[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (4) : 472 -476 . DOI: 10.13699/j.cnki.1001-6821.2025.04.005

参考文献

收起

文献

收起

参考文献引证文献

排序方式：

2025年第41卷第4期

PDF下载

引用本文

BibTeX

文章信息

doi: 10.13699/j.cnki.1001-6821.2025.04.005

接收时间：2024-08-19
首发时间：2026-08-04
出版时间：2025-02-28

补充材料

相关文章

文章信息

作者

出版历史

收稿日期：2024-08-19

基金

作者信息

^1a.浙江大学医学院附属金华医院/金华市中心医院，麻醉科，浙江金华 321000

^1b.浙江大学医学院附属金华医院/金华市中心医院，泌尿科，浙江金华 321000

通讯作者:

唐智豪，副主任医师 MP: 13757981567 E-mail: tzhao1226@163.com

参考文献

分享链接

https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.04.005

分享至

全文二维码

扫描看全文

引用本文

BibTeX

本文的引用情况

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

关闭全屏

BibTeX
EndNote
RefWorks
TxT