摘要
目的对比艾司氯胺酮与阿片类药物对腹腔镜结肠癌手术患者炎性因子的影响。方法本研究在全身麻醉下行腹腔镜下结肠癌根治术患者60例,分为阿片组即(O组)与艾司氯胺酮组(K组),观察两组患两组者入室时(T_(1)),麻醉诱导后5 min(T_(2)),手术结束时(T_(3))、术后24 h(T_(4))的动脉收缩压、动脉舒张压、心率及术后拔管所需时间、恶心呕吐的情况以血清IL-6、IL-10的水平。结果与入室时相比,手术结束时艾司氯胺酮组及阿片组的IL-6、IL-10明显升高(P<0.05),两组IL-10在手术结束均升高,术后24 h艾司氯胺酮组的IL-6、IL-10明显较入室时升高,阿片组IL-6明显升高、IL-10无明显变化。两组之间比较,艾司氯胺酮组手术结束及术后24 h的IL-6较阿片组低,而IL-10明显高于阿片组(P<0.05)。结论艾司氯胺酮可减少腹腔镜结肠癌患者IL-6的释放,增加IL-10的分泌,具有抗炎作用,艾司氯胺酮可以安全、有效的用于结肠癌手术患者的麻醉,还可以减少阿片类药物的使用,缩短了患者的住院时间,有利于患者的术后康复。
Objective To compare the effects of esketamine and opioids on inflammatory factors in patients undergoing laparoscopic colon cancer surgery.Methods A total of 60 patients undergoing laparoscopic radical resection of colon cancer under general anesthesia were divided into two groups,opioid group(group O)and esketamine group(group K).Arterial systolic blood pressure,arterial diastolic blood pressure,heart rate,postoperative extubation time,nausea and vomiting,as well as serum IL-6 and IL-10 levels were observed at the time of entry(T_(1)),5 minutes after induction of anesthesia(T_(2)),at the end of surgery(T_(3)),and 24 hours after surgery(T_(4)).Results IL-6 and IL-10 levels in the esketamine group and the opioid group were significantly increased at the end of the surgery compared with the time of entry,(P<0.05).IL-10 levels in both groups were increased after surgery,and IL-6 and IL-10 in the esketamine group were significantly increased than that at the time of entry 24 hours after the operation.IL-6 in the opioid group were significantly increased,while IL-10 had no significant change.Between the two groups,IL-6 level at the end of surgery and 24hours after surgery was lower in the esketamine group than that in the opioid group,while IL-10 level was significantly higher in the esketamine group than that in the opioid group(P<0.05).Conclusion Esketamine can reduce the release of IL-6 and increase the secretion of IL-10 in patients with laparoscopic colon cancer,thereby exerting anti-inflammatory effects.Esketamine can be safe and effective for patients undergoing anesthesia in colon cancer surgery,it can also reduce the need for opioids,shorten hospital stay,and facilitate postoperative recovery.
作者
冀佳佳
祖丽胡玛尔
张海平
周丽霞
毛少磊
JI Jiajia;Zulihumaer;ZHANG Haiping;ZHOU Lixia;MAO Shaolei(Deparment of Anesthsiology,People's Hospital of Bayingolin Mongolian Autonomous Prefecture,Korla,Xinjiang,841000,China)
出处
《新疆医学》
2024年第2期131-135,共5页
Xinjiang Medical Journal
基金
巴音郭楞蒙古自治州科学技术研究计划项目(项目编号:202211)。
关键词
艾司氯胺酮
结肠癌
炎性因子
Esketamine
colon cancer
inflammatory factors