Fu Mengyue, Xu Rui, Chen Guizhen, Zheng Xuemei, Shu Bin, Huang He, Duan Guangyou, Chen Yuanjing
Department of Anaesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Heliyon. 2024 Jan 24;10(3):e25100. doi: 10.1016/j.heliyon.2024.e25100. eCollection 2024 Feb 15.
Pain management after lung resection plays a crucial role in reducing postoperative pulmonary complications (PPCs). This study aimed to examine the effect of postoperative esketamine infusion as an adjunct to opioid analgesia on ventilation and pulmonary complications in patients underwent lung resection.
Patients undergoing video-assisted thoracoscopic lung resection were randomly assigned to either the esketamine group or the control group. The esketamine group received a 24-h infusion of 1.5 mcg/ml sufentanil combined with 0.75 mcg/ml esketamine after surgery, while the control group received 1.5 mcg/ml sufentanil alone. The primary outcome measure was low minute ventilation, and the secondary outcome measures were hypoxemia, PaO2/FiO2 levels, postoperative pulmonary complications, hospital stay duration, ambulation time, Visual Analogue Scale (VAS) score, depression and anxiety levels, sleep quality, and analgesia satisfaction.
80 patients were randomly divided into two groups: the esketamine group (n = 40) and the control group (n = 40). The esketamine group exhibited notably reduced incidence of low minute ventilation (P = 0.014), lower occurrence of postoperative pulmonary complications (PPCs) compared to the control group (P = 0.039), and decreased incidence of hypoxemia (P = 0.003). Furthermore, the esketamine group showed improved outcomes with lower VAS scores on the second postoperative day and enhanced sleep quality (P < 0.001) after the surgery.
Postoperative esketamine infusion with opioids improved ventilation and reduced PPCs after lung resection, warranting further clinical studies.
This study was registered on ClinicalTrials.gov (Trial ID: NCT05458453, https://clinicaltrials.gov/ct2/show/NCT05458453).
肺切除术后的疼痛管理在减少术后肺部并发症（PPCs）方面起着至关重要的作用。本研究旨在探讨术后输注艾司氯胺酮作为阿片类镇痛辅助药物对肺切除患者通气和肺部并发症的影响。
接受电视辅助胸腔镜肺切除术的患者被随机分为艾司氯胺酮组或对照组。艾司氯胺酮组术后接受24小时输注1.5微克/毫升舒芬太尼联合0.75微克/毫升艾司氯胺酮，而对照组仅接受1.5微克/毫升舒芬太尼。主要观察指标为低分钟通气量，次要观察指标为低氧血症、PaO2/FiO2水平、术后肺部并发症、住院时间、下床活动时间、视觉模拟评分（VAS）、抑郁和焦虑水平、睡眠质量以及镇痛满意度。
80例患者被随机分为两组：艾司氯胺酮组（n = 40）和对照组（n = 40）。艾司氯胺酮组低分钟通气量的发生率显著降低（P = 0.014），与对照组相比，术后肺部并发症（PPCs）的发生率更低（P = 0.039），低氧血症的发生率也降低（P = 0.003）。此外，艾司氯胺酮组在术后第二天VAS评分更低，术后睡眠质量改善（P < 0.001）。
术后艾司氯胺酮与阿片类药物联合输注可改善肺切除术后的通气并减少PPCs，值得进一步开展临床研究。
本研究已在ClinicalTrials.gov上注册（试验编号：NCT05458453，https://clinicaltrials.gov/ct2/show/NCT05458453）。
