Clinical study of esketamine for intraoperative analgesic management in burn patients
10.3969/j.issn.1008-9691.2024.06.016
- VernacularTitle:艾司氯胺酮用于烧伤患者术中镇痛管理的临床研究
- Author:
Yang LIU
1
;
Mengmeng LI
;
Lingjing LIU
;
Yu SUN
;
Qun XIE
;
Guoxin GU
Author Information
1. 解放军总医院第四医学中心麻醉科,北京 100048;锦州医科大学解放军总医院第四医学中心研究生培养基地,北京 100048
- Publication Type:Journal Article
- Keywords:
Esketamine;
Sufentanil;
Anesthesia management;
Burn
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(6):730-734
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of esketamine on intraoperative analgesic management of burn patients.Methods A prospective randomized controlled study was conducted in which 104 patients with scab grafting under general anesthesia in the Fourth Medical Center of the PLA General Hospital from December 2023 to September 2024 were selected as the study subjects.The patients were divided into esketamine group and sufentanil group according to random number table method,with 52 cases in each group.Basic data,laboratory examination indicators,perioperative circulation of patients[including mean arterial pressure(MAP),heart rate(HR)],perioperative anxiety and pain scales[including self-rating anxiety scale(SAS),visual analog scale for anxiety(VAS-A),visual analog scale for pain(VAS-P),numerical rating scale(NRS),and the occurrence of postoperative adverse reactions.Results After excluding 6 patients who withdrew and 3 who required changes in anesthesia,95 patients completed the study(47 in the esketamine group and 48 in the sufentanil group).Compared with sufentanil group,patients in the two groups had stable intraoperative circulation,esketamine group had higher MAP at 2 minutes after anesthesia intubation(T3),at intraoperative skin removal(T4),at intraoperative skin grafting(T5),and at exit room(T6),HR was faster at T3-T5(P<0.05),and the time from surgery to extubation was extended[minutes:7.0(5.0,11.0)vs.5.0(3.8,8.3),P<0.05],the first exhaust time was significantly shortened[hours:3.8(1.5,7.3)vs.6.2(3.4,10.5),P<0.05],the proportion of increased secretion during recovery period was significantly higher[36.2%(17/47)vs.16.7%(8/48),P<0.05],and the VAS-P score at rest 24 hours after surgery[0.0(0.0,1.0)vs.0.5(0.0,1.0),P<0.05]and VAS-P score during exercise[1.5(1.0,2.0)vs.2.0(1.0,3.0),P<0.05]were significantly lower.There were no significant differences in anesthesia drug consumption and postoperative adverse reactions between the two groups.Conclusion Esketamine is safe and feasible for intraoperative analgesia management of burn patients,and it is a potential drug for perioperative frugal opioid anesthesia management.
