Effects of esketamine combined with ultrasound-guided stellate ganglion block on stress response and postoperative immune function in elderly patients undergoing enterectomy
10.3969/j.issn.1000-484X.2025.02.022
- VernacularTitle:艾司氯胺酮复合超声引导下星状神经节阻滞对老年结直肠切除术患者应激反应和术后免疫功能的影响
- Author:
Xiumei FENG
1
;
Shanshan MAO
;
Rui HU
;
Ju GAO
Author Information
1. 扬州大学医学院,扬州 225000;南京中医药大学附属徐州市中医院麻醉科,徐州 221000;扬州大学临床医学院江苏省苏北人民医院麻醉科,扬州 225000
- Publication Type:Journal Article
- Keywords:
Esketamine;
Ultrasound-guided stellate ganglion block;
Enterectomy;
Stress response;
Immune response
- From:
Chinese Journal of Immunology
2025;41(2):393-397
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate effect of esketamine combined with ultrasound-guided stellate ganglion block(SGB)on stress response and postoperative immune function in elderly patients undergoing colorectal resection.Methods:A retrospective analy-sis was conducted in clinical data from 70 cases of elderly patients undergoing elective colorectal resection in Xuzhou Hospital of Tradi-tional Chinese Medicine,Nanjing University of Chinese Medicine from September 2020 to April 2022,who were randomly divided into observation group(n=35)and control group(n=35),control group was treated with ultrasound-guided SGB,observation group was treated with esketamine combined ultrasound-guided SGB.Heart rate(HR),mean arterial pressure(MAP),product of heart rate and systolic blood pressure(RPP)and stress response levels[cortisol(CORT),SOD,MDA,IL-6,TNF-α,IL-1β]were compared between two groups at 5 min before SGB(t0),immediately after tracheal intubation(t1),1 h after operation(t2)and end of operation(t3).CD3+T,CD4+T,CD8+T and CD4+T/CD8+T at t0,t3,24 h after operation(t4)and 72 h after operation(t5)were compared,respec-tively.Recovery time,first exhaust time,bowel sound recovery time and first oral feeding time and incidence of adverse reactions during anesthesia were compared between two groups.Results:HR,MAP,RPP,CORT,SOD,MDA,IL-6,TNF-α,IL-1β,CD3+T,CD4+T,CD8+T and CD4+T/CD8+T at different time points in two groups were compared by repeated measures analysis of variance,and there were significant differences between groups and at different time points(P<0.05).Compared with control group,observation group had shorter recovery time,first exhaust time,bowel sound recovery time,first oral feeding time,postoperative time out of bed(P<0.05),and less intraoperative pain medication consumption,incidence of adverse reactions during anesthesia was reduced[48.57%(17/35)vs 25.71%(9/35),P<0.05].Conclusion:Esketamine combined with ultrasound-guided SGB in elderly patients undergoing enterectomy can promote recovery of postoperative gastrointestinal function,reduce perioperative stress response,has little impact on immune function of patients,reduce perioperative adverse reactions.
