艾司氯胺酮联合右美托咪定麻醉前处理对腹腔镜胆囊切除术治疗胆囊结石患者术后睡眠质量和情绪状态的影响*

doi:10.3969/j.issn.1672-5069.2025.02.038

Abstract

Abstract: Objective This study aimed to investigate analgesia and sedation effects of pretreatment of esketamine and dexmedetomidine in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy(LC). Methods 113 patients with cholecystolithiasis were encountered in our hospital between November 2022 and April 2024, and all underwent LC. Before anesthesia, patients were randomly divided into group D (n=37), group ED (n=38) and group C (n=38) to receive intravenous pumping of dexmedetomidine, esketamine and dexmedetomidine or normal saline for pretreatment. Postoperative sleep quality was assessed by Athens insomnia scale(AIS)and Pittsburgh sleep quality index(PSQI), emotional state was evaluated by self-rating anxiety scale (SAS) scores and self-rating depression scale (SDS) scores,postoperative pain was evaluated by NRS scores, and sedative effect was evaluated by Ramsay scores. Results At postoperative day 1(POD1) and POD3,AIS and PSQI scores in group ED were(8.4±1.3)points and (6.8±1.4)points, both much lower than [(8.7±1.1)points and (6.9±1.7)points, P＜0.05] in group D or [(9.7±1.1)points and (8.5±1.1)points, P＜0.05] in group C, PSQI scores were (9.1±1.3)points and (7.7±1.5)points, both much lower than [(9.2±1.5)points and (7.9±1.4)points, P＜0.05] in group D or [(10.9±2.3)points and (8.9±1.8)points, P＜0.05] in group C; at POD1, SAS and SDS scores in group ED and group D were much lower than in group C (P＜0.05); at extubation, 24 hours and 72 hours after operation, NRS scores in group ED and group D were much lower than in group C(P＜0.05); dose of sufentanil given for analgesia after operation in group ED was much smaller than in group D or group C (P＜0.05). Conclusion Pretreatment of esketamine and dexmedetomidine in patients with cholecystolithiasis undergoing LC could effectively alleviate postoperative pain, relieve depression and anxiety, and thereby enhance overall postoperative sleep quality.

Key words: Cholecystolithiasis, Laparoscopic cholecystectomy, Dexmedetomidine, Esketamine, Anesthesia, Postoperative sleep quality, Emotion

Zhang Yingxuan, Wang Yiqian, Xie Chenglan, et al. Pretreatment of esketamine and dexmedetomidine in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy[J]. Journal of Practical Hepatology, 2025, 28(2): 310-313.

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Pretreatment of esketamine and dexmedetomidine in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy

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