Wang Dongdong, Weng Mengcao, Chen Kunwei, Wu Xiaojun, Xiao Yuanfang, Wu Yijie, Qian Minyue, Lu Zhongteng, Fang Xiangming, Jin Yue
Department of Anesthesiology and Intensive Care, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Anesthesiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
BMJ Open. 2025 May 30;15(5):e098558. doi: 10.1136/bmjopen-2024-098558.
Subanaesthetic doses of esketamine may attenuate the opioid-induced cough reflex and prevent intraoperative haemodynamic fluctuations. This study aims to evaluate the effect of subanaesthetic doses of esketamine on the quality of recovery in patients who underwent abdominal surgery.
Retrospective cohort study using propensity score matching (PSM) methodology.
A tertiary academic hospital.
Patients who underwent abdominal surgery under general anaesthesia with tracheal intubation between 20 December 2022 and 30 April 2023, were retrospectively reviewed. Patients were assigned to the esketamine or control group based on whether they received a subanaesthetic dose of esketamine.
The primary outcome was extubation time (T1). Secondary outcomes included post-anaesthesia care unit (PACU) observation time (T2), total PACU time (T3), postoperative pain at multiple time points and adverse events including respiratory depression, hypertension and others.
A total of 2177 patients underwent abdominal surgery. After PSM, 1196 patients were analysed, 598 in each group. Esketamine significantly reduced the extubation time compared with the control group (20.00 vs 23.00 min, p=0.001). Total PACU time was shorter in the esketamine group than in the control group (62 vs 66 min, p=0.015), although PACU observation time did not show a significant difference. Compared with the control group, the esketamine group had a lower incidence of severe postoperative pain immediately after extubation (0.33% vs 2.01%, p=0.007) and respiratory depression (2.68% vs 5.35%, p=0.027), but a higher incidence of hypertension (9.53% vs 6.35%, p=0.042). There were no other significant differences in adverse events between the two groups.
The use of subanaesthetic doses of esketamine for induction of anaesthesia in patients undergoing abdominal surgery may shorten the extubation time and reduce the incidence of postoperative complications.
ChiCTR2300072154.
亚麻醉剂量的艾司氯胺酮可能减弱阿片类药物引起的咳嗽反射并预防术中血流动力学波动。本研究旨在评估亚麻醉剂量的艾司氯胺酮对接受腹部手术患者恢复质量的影响。
采用倾向评分匹配（PSM）方法的回顾性队列研究。
一家三级学术医院。
回顾性分析了2022年12月20日至2023年4月30日期间接受全身麻醉气管插管下腹部手术的患者。根据患者是否接受亚麻醉剂量的艾司氯胺酮，将其分为艾司氯胺酮组或对照组。
主要结局为拔管时间（T1）。次要结局包括麻醉后恢复室（PACU）观察时间（T2）、PACU总时间（T3）、多个时间点的术后疼痛以及包括呼吸抑制、高血压等在内的不良事件。
共有2177例患者接受了腹部手术。PSM后，分析了1196例患者，每组598例。与对照组相比，艾司氯胺酮显著缩短了拔管时间（20.00对23.00分钟，p=0.001）。艾司氯胺酮组的PACU总时间比对照组短（62对66分钟，p=0.015），尽管PACU观察时间无显著差异。与对照组相比，艾司氯胺酮组拔管后即刻重度术后疼痛的发生率较低（0.33%对2.01%，p=0.007），呼吸抑制的发生率也较低（2.68%对5.35%，p=0.027），但高血压的发生率较高（9.53%对6.35%，p=0.042）。两组在不良事件方面无其他显著差异。
在接受腹部手术的患者中使用亚麻醉剂量的艾司氯胺酮进行麻醉诱导可能会缩短拔管时间并降低术后并发症的发生率。
ChiCTR2300072154。
