目前,全球生育率虽在下降,但是各国的剖宫产率持续上升,随之而来的产后痛成为大众关注的焦点,其次产后抑郁也给母婴,社会带来了巨大的负担,所以产后镇痛及抗抑郁对于剖宫产母婴,产科舒适化医疗至关重要。而艾司氯胺酮相比于氯胺酮,不仅...目前,全球生育率虽在下降,但是各国的剖宫产率持续上升,随之而来的产后痛成为大众关注的焦点,其次产后抑郁也给母婴,社会带来了巨大的负担,所以产后镇痛及抗抑郁对于剖宫产母婴,产科舒适化医疗至关重要。而艾司氯胺酮相比于氯胺酮,不仅抗抑郁作用快速,效果显著,且镇痛效果更好,同时在体内代谢较快,相关不良反应少,对母婴安全,已经被广泛用于剖宫产产妇术后镇痛,但其最适剂量有待商榷。本文通过综述目前已发表的关于不同浓度的艾司氯胺酮联合其他镇痛药用于产妇术后镇痛及抗抑郁的文章,对比不同浓度下的作用效果及不良反应,以期为未来研究剖宫产术后静脉自控镇痛提供新的研究方向,以及为探究艾司氯胺酮用于产妇术后镇痛抗抑郁的最佳用药方案提供参考。Currently, although the global fertility rate is declining, the rate of cesarean delivery continues to rise. Consequently, postpartum pain has become a focal point of public concern. Additionally, postpartum depression poses a significant burden on mothers, infants, and society. Therefore, effective postpartum analgesia and antidepression measures are crucial for the well-being of cesarean mothers and infants, as well as for the advancement of comfortable obstetric care. Esketamine, compared to ketamine, not only offers rapid and significant antidepression effects, but also provides better analgesia. Additionally, it metabolizes more quickly in the body, has fewer associated adverse reactions, and is safe for both mother and infant. It has been widely used for postoperative analgesia in cesarean delivery patients, though the optimal dosage remains to be determined. This article reviews the published studies on the use of esketamine at different concentrations in combination with other analgesics for postoperative analgesia and antidepression effects in parturients. By comparing the effects and adverse reactions at different concentrations, it aims to provide new directions for future research on postoperative patient-controlled analgesia after cesarean delivery and to offer a reference for determining the best dosing regimen for esketamine in postoperative analgesia and antidepression treatment for parturients.展开更多
身体质量指数(Body Mass Index, BMI)是评估体重状态的常用工具,其计算公式为体重(kg)除以身高(m2)的平方。BMI可以分类为正常体重(18.5~24.9 kg/m2)、超重(25~29.9 kg/m2)和肥胖(≥30 kg/m2)。肥胖不仅增加了多种健康风险,如心血管疾...身体质量指数(Body Mass Index, BMI)是评估体重状态的常用工具,其计算公式为体重(kg)除以身高(m2)的平方。BMI可以分类为正常体重(18.5~24.9 kg/m2)、超重(25~29.9 kg/m2)和肥胖(≥30 kg/m2)。肥胖不仅增加了多种健康风险,如心血管疾病、糖尿病和高血压,还对围手术期的疼痛管理产生了重要影响。围手术期疼痛管理涵盖术前评估、术中疼痛控制以及术后疼痛管理,对患者的恢复和生活质量有着深远的影响。因此,研究BMI对围手术期疼痛的影响具有重要的临床意义。本综述旨在系统总结BMI对围手术期疼痛的影响。通过回顾当前研究成果,为临床实践提供改进疼痛管理策略的参考,以提高肥胖患者的术后恢复质量。Body Mass Index (BMI) is a common tool for assessing weight status. Its calculation formula is weight (kg) divided by the square of height (m2). BMI can be classified into normal weight (18.5~24.9 kg/m2), overweight (25~29.9 kg/m2) and obesity (≥30 kg/m2). Obesity not only increases a variety of health risks, such as cardiovascular disease, diabetes and hypertension, but also has an important impact on pain management during the perioperative period. Perioperative pain management covers preoperative evaluation, intraoperative pain control and postoperative pain management, which has a profound impact on patients’ recovery and quality of life. Therefore, it is of great clinical significance to study the effect of BMI on perioperative pain. This review aims to systematically summarize the impact of BMI on perioperative pain. By reviewing the current research results, it provides references for clinical practice to improve pain management strategies to improve the quality of postoperative recovery of obese patients.展开更多
目的探讨艾司氯胺酮复合椎旁神经阻滞麻醉在单孔胸腔镜肺大疱切除术中的效果评估。方法选取2022年1月至2022年8月内蒙古医科大学附属医院胸外科收治的气胸患者60例为研究对象。采用随机数表法分为两组,全身麻醉双腔气管插管组(G组),艾...目的探讨艾司氯胺酮复合椎旁神经阻滞麻醉在单孔胸腔镜肺大疱切除术中的效果评估。方法选取2022年1月至2022年8月内蒙古医科大学附属医院胸外科收治的气胸患者60例为研究对象。采用随机数表法分为两组,全身麻醉双腔气管插管组(G组),艾司氯胺酮+椎旁神经阻滞麻醉组(E组)。记录两组的MAP、HR、BIS、PaCO_(2)、PaO_(2)、Lac、Glu;麻醉苏醒时间、PACU停留时间;术后6 h VAS评分、拔出引流管时间及住院时间等。结果E组PaO_(2)较G组偏低,PaCO_(2)较G组偏高,差异有统计学意义(P<0.05)。术后6 h VAS评分E组明显低于G组,差异有统计学意义(P<0.05)。术后恶心呕吐、咽喉疼痛、咳嗽等发生率E组显著低于G组,差异有统计学意义(P<0.05)。E组的PACU停留时间、术后拔除引流管时间和住院时间较G组短,差异有统计学意义(P<0.05)。结论艾司氯胺酮复合超声引导下椎旁神经阻滞麻醉用于单孔胸腔镜肺大疱切除术,麻醉效果确切,患者术后疼痛发生率低、麻醉并发症少、住院时间短,值得临床推广。展开更多
目的探讨全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能及镇痛效果的影响。方法择期行全关节成形术的老年患者80例,随机及分为全身麻醉组(n=40)和硬膜外麻醉组(n=40)两组,对两组临床疗效、简易智力状态检查量表(MMSE)评分、...目的探讨全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能及镇痛效果的影响。方法择期行全关节成形术的老年患者80例,随机及分为全身麻醉组(n=40)和硬膜外麻醉组(n=40)两组,对两组临床疗效、简易智力状态检查量表(MMSE)评分、视觉模拟评分(VAS)、手术时间、麻醉时间、围术期输液量及输血量、下床锻炼时间、出院时间、感觉阻滞起效时间及恢复时间、运动阻滞起效时间及恢复时间、血流动力学、凝血功能指标及D-二聚体水平、术后并发症发生情况进行统计分析。结果硬膜外麻醉组麻醉优良率显著高于全身麻醉组,术后1 d VAS显著低于全身麻醉组,感觉阻滞起效时间、运动阻滞起效时间均显著短于全身麻醉组,感觉阻滞恢复时间、运动阻滞恢复时间均显著长于全身麻醉组,麻醉后6 h、术后1 d的D-二聚体水平均显著低于全身麻醉组,术后并发症发生率显著低于全身麻醉组(均P<0.05)。结论全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能具有相似的影响,但后者较前者具有较好的镇痛效果。展开更多
文摘目前,全球生育率虽在下降,但是各国的剖宫产率持续上升,随之而来的产后痛成为大众关注的焦点,其次产后抑郁也给母婴,社会带来了巨大的负担,所以产后镇痛及抗抑郁对于剖宫产母婴,产科舒适化医疗至关重要。而艾司氯胺酮相比于氯胺酮,不仅抗抑郁作用快速,效果显著,且镇痛效果更好,同时在体内代谢较快,相关不良反应少,对母婴安全,已经被广泛用于剖宫产产妇术后镇痛,但其最适剂量有待商榷。本文通过综述目前已发表的关于不同浓度的艾司氯胺酮联合其他镇痛药用于产妇术后镇痛及抗抑郁的文章,对比不同浓度下的作用效果及不良反应,以期为未来研究剖宫产术后静脉自控镇痛提供新的研究方向,以及为探究艾司氯胺酮用于产妇术后镇痛抗抑郁的最佳用药方案提供参考。Currently, although the global fertility rate is declining, the rate of cesarean delivery continues to rise. Consequently, postpartum pain has become a focal point of public concern. Additionally, postpartum depression poses a significant burden on mothers, infants, and society. Therefore, effective postpartum analgesia and antidepression measures are crucial for the well-being of cesarean mothers and infants, as well as for the advancement of comfortable obstetric care. Esketamine, compared to ketamine, not only offers rapid and significant antidepression effects, but also provides better analgesia. Additionally, it metabolizes more quickly in the body, has fewer associated adverse reactions, and is safe for both mother and infant. It has been widely used for postoperative analgesia in cesarean delivery patients, though the optimal dosage remains to be determined. This article reviews the published studies on the use of esketamine at different concentrations in combination with other analgesics for postoperative analgesia and antidepression effects in parturients. By comparing the effects and adverse reactions at different concentrations, it aims to provide new directions for future research on postoperative patient-controlled analgesia after cesarean delivery and to offer a reference for determining the best dosing regimen for esketamine in postoperative analgesia and antidepression treatment for parturients.
文摘身体质量指数(Body Mass Index, BMI)是评估体重状态的常用工具,其计算公式为体重(kg)除以身高(m2)的平方。BMI可以分类为正常体重(18.5~24.9 kg/m2)、超重(25~29.9 kg/m2)和肥胖(≥30 kg/m2)。肥胖不仅增加了多种健康风险,如心血管疾病、糖尿病和高血压,还对围手术期的疼痛管理产生了重要影响。围手术期疼痛管理涵盖术前评估、术中疼痛控制以及术后疼痛管理,对患者的恢复和生活质量有着深远的影响。因此,研究BMI对围手术期疼痛的影响具有重要的临床意义。本综述旨在系统总结BMI对围手术期疼痛的影响。通过回顾当前研究成果,为临床实践提供改进疼痛管理策略的参考,以提高肥胖患者的术后恢复质量。Body Mass Index (BMI) is a common tool for assessing weight status. Its calculation formula is weight (kg) divided by the square of height (m2). BMI can be classified into normal weight (18.5~24.9 kg/m2), overweight (25~29.9 kg/m2) and obesity (≥30 kg/m2). Obesity not only increases a variety of health risks, such as cardiovascular disease, diabetes and hypertension, but also has an important impact on pain management during the perioperative period. Perioperative pain management covers preoperative evaluation, intraoperative pain control and postoperative pain management, which has a profound impact on patients’ recovery and quality of life. Therefore, it is of great clinical significance to study the effect of BMI on perioperative pain. This review aims to systematically summarize the impact of BMI on perioperative pain. By reviewing the current research results, it provides references for clinical practice to improve pain management strategies to improve the quality of postoperative recovery of obese patients.
文摘目的探讨艾司氯胺酮复合椎旁神经阻滞麻醉在单孔胸腔镜肺大疱切除术中的效果评估。方法选取2022年1月至2022年8月内蒙古医科大学附属医院胸外科收治的气胸患者60例为研究对象。采用随机数表法分为两组,全身麻醉双腔气管插管组(G组),艾司氯胺酮+椎旁神经阻滞麻醉组(E组)。记录两组的MAP、HR、BIS、PaCO_(2)、PaO_(2)、Lac、Glu;麻醉苏醒时间、PACU停留时间;术后6 h VAS评分、拔出引流管时间及住院时间等。结果E组PaO_(2)较G组偏低,PaCO_(2)较G组偏高,差异有统计学意义(P<0.05)。术后6 h VAS评分E组明显低于G组,差异有统计学意义(P<0.05)。术后恶心呕吐、咽喉疼痛、咳嗽等发生率E组显著低于G组,差异有统计学意义(P<0.05)。E组的PACU停留时间、术后拔除引流管时间和住院时间较G组短,差异有统计学意义(P<0.05)。结论艾司氯胺酮复合超声引导下椎旁神经阻滞麻醉用于单孔胸腔镜肺大疱切除术,麻醉效果确切,患者术后疼痛发生率低、麻醉并发症少、住院时间短,值得临床推广。
文摘目的探讨全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能及镇痛效果的影响。方法择期行全关节成形术的老年患者80例,随机及分为全身麻醉组(n=40)和硬膜外麻醉组(n=40)两组,对两组临床疗效、简易智力状态检查量表(MMSE)评分、视觉模拟评分(VAS)、手术时间、麻醉时间、围术期输液量及输血量、下床锻炼时间、出院时间、感觉阻滞起效时间及恢复时间、运动阻滞起效时间及恢复时间、血流动力学、凝血功能指标及D-二聚体水平、术后并发症发生情况进行统计分析。结果硬膜外麻醉组麻醉优良率显著高于全身麻醉组,术后1 d VAS显著低于全身麻醉组,感觉阻滞起效时间、运动阻滞起效时间均显著短于全身麻醉组,感觉阻滞恢复时间、运动阻滞恢复时间均显著长于全身麻醉组,麻醉后6 h、术后1 d的D-二聚体水平均显著低于全身麻醉组,术后并发症发生率显著低于全身麻醉组(均P<0.05)。结论全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能具有相似的影响,但后者较前者具有较好的镇痛效果。
