艾司氯胺酮联合股神经阻滞喉罩全麻在膝关节镜手术中的应用

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Abstract Objective To investigate and analyze the application of Esketamine combined with femoral nerve block laryngeal general anesthesia in knee arthroscopic surgery.Methods A total of 72 patients with knee arthroscopy in the First Hospital of Nanping City from March 2020 to May 2021 were selected as the research subjects.The patients were divided into control group and observation group by random number table method,36 cases in each group.The control group adopted ultrasound-guided femoral nerve block after the onset of laryngeal general anesthesia,and the observation group adopted Esketamine on the basis of the control group.The heart rate (HR) and mean arterial pressure (MAP)of the two groups were compared before anesthesia (T0),before skin incision (T1),immediately after skin incision (T2),intraoperative exploration (T3) and after surgery (T4).The duration of sensory block and motor block were compared between the two groups.Visual analogue scale (VAS) scores were compared between the two groups immediately after extubation and 0.5,8,and 24 h after operation.Perioperative adverse reactions were compared between the two groups.Results There were no significant differences in HR and MAP at T0 between the two groups (P＞0.05).HR of T1,T2,T3 and T4 in the observation group were higher than those in the control group,and MAP of T1,T2 and T3 were higher than those in the control group,and the differences were statistically significant (P＜0.05).In the control group,the HR of T1,T2,T3 and T4 was lower than that of T0,and the MAP of T1,T2 and T3 was lower than that of T0.In the observation group,MAP of T3 was lower than that of T0,and the differences were statistically significant (P＜0.05).There was no significant difference in the duration of sensory block and motor block between the two groups (P＞0.05).The VAS scores of the observation group immediately after extubation,0.5 and 8 h after operation were lower than those of the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Ultrasound-guided femoral nerve block and laryngeal mask general anesthesia with the addition of Esketamine in knee arthroscopy to ensure more stable hemodynamics,and the postoperative pain level is low,doesn't increase perioperative adverse reactions,and has higher safety.

Key words： Esketamine Femoral nerve block Knee arthroscopy Hemodynamics Pain level Adverse reactions Safety

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[1]	齐立杰，张勇，钮絮，等.肌间沟臂丛神经阻滞复合静脉全麻对肩关节镜手术患者麻醉效果、MAP、HR 以及血清Cor、NE 的影响[J].现代生物医学进展，2020，20（16）：3152-3155，3077.
[2]	吕广华，梁家新，李德剑，等.股神经阻滞麻醉对膝关节置换术患者术后康复效果的影响[J].医学临床研究，2019，36（6）：1190-1192.
[3]	顾志俭，周海军，徐炜.超声引导下股神经阻滞联合全身麻醉对高龄膝关节镜手术患者镇痛和术后谵妄的影响[J].广西医学，2021，43（13）：1566-1569.
[4]	中华医学会麻醉学分会，老年人麻醉学组，骨科麻醉学组，等.中国老年患者膝关节手术围手术期麻醉管理指导意见（2020 版）[J].中华医学杂志，2020，100（45）：3566-3577.
[5]	Perry JA，Douglas H.Immunomodulatory Effects of Surgery，Pain，and Opioids in Cancer Patients[J].Vet Clin NorthAm SmallAnim Pract，2019，49（6）：981-991.
[6]	任晓燕，姜艳华，郭丽丽，等.超声引导下股神经-腘窝坐骨神经阻滞麻醉应用于膝关节镜手术的临床效果[J].实用临床医药杂志，2020，4（13）：84-86.
[7]	梁宇斌，肖俊枫，蔡立泉.关节镜下膝关节前交叉韧带重建的远期临床效果及常见影响因素[J].中国医药科学，2021，11（14）：205-208，230.
[8]	李正南，王一海，杨康骅，等.关节镜联合微创切口治疗膝关节脱位合并多韧带损伤的临床效果[J].中国当代医药，2020，27（13）：44-46，50.
[9]	吴勇.超声引导下臂丛神经阻滞复合喉罩全身麻醉在上肢手术患者中的应用效果[J]．医疗装备，2019，32（15）：113-114.
[10]	齐乐.膝关节镜手术患者术中护理关键点质量控制的应用价值[J].中国伤残医学，2020，（21）：89-90.
[11]	代晨旭，蔡宁，官双双，等．腰丛联合坐骨神经阻滞与股-闭孔-坐骨神经阻滞在全膝关节置换术的临床效果比较[J]．解放军预防医学杂志，2019，16（8）：541-543．
[12]	赵毅.B 超引导下股神经阻滞联合腘窝坐骨神经阻滞麻醉在膝关节镜手术中的应用效果[J].当代医药论丛，2021，19（16）：2-4.
[13]	武婕，夏艳，柯雪茹．地塞米松对氯胺酮麻醉后幼鼠认知功能及海马Caveolin-1 表达的影响[J]．中国药师，2020，23（1）：29-33．
[14]	邹涛晖，柴淑杰.超声引导下股神经联合侧入路腘窝坐骨神经阻滞用于膝关节镜手术麻醉效果分析[J].中国医疗器械信息，2021，27（13）：77-78.
[15]	何燕.喉罩全身麻醉辅助臂丛麻醉与艾司氯胺酮辅助臂丛麻醉对患儿警觉/镇静评分及术后苏醒时间的影响[J].药物与临床，2021，21（4）：597-599.
[16]	赵燕侠.膝关节镜手术中局部麻醉和脊椎麻醉的临床对比研究[J].中国伤残医学，2020，28（1）：94-95.
[17]	黄永华，黄志伟，梁国森.超声引导下肢神经阻滞在膝关节镜手术的麻醉及术后镇痛方面的效果[J].影像研究与医学应用，2020，4（19）：105-107.
[18]	游弋.超声引导下股神经联合侧入路腘窝坐骨神经阻滞用于膝关节镜手术的麻醉效果[J].中国社区医师，2020，36（3）：95-96.
[19]	沈国灿，李超，朱洪宽，等.盐酸右美托咪定在膝关节镜手术腰硬联合麻醉中的安全性及VAS 和Ramsay 评分影响分析[J].当代医学，2020，26（36）：11-14.
[20]	汲晓丽.超声引导下腰丛-坐骨神经阻滞在老年患者膝关节镜手术中的应用[J].全科口腔医学杂志（电子版），2020，7（2）：147-156.