【摘要】 目的 探讨艾司氯胺酮对妇科腹腔镜手术患者术后恢复质量及焦虑、抑郁情绪的影响。方法 择期妇科腹腔镜手术患者63例分为E组（31例）和C组（32例）。E组麻醉诱导期静脉注射艾司氯胺酮0.3mg/kg,麻醉维持期静脉泵注艾司氯胺酮0.2mg·kg^-1·h^-1;C组麻醉诱导期和麻醉维持期分别静脉注射和静脉泵注等体积生理盐水。比较两组围手术期的40项恢复质量量表（QoR-40）评分、焦虑自评量表（SAS）评分和抑郁自评量表（SDS）评分，比较两组术中丙泊酚和瑞芬太尼用量、苏醒时间、出室时间、术后1、3、6、12、24h的VAS疼痛评分、术后不良反应发生率以及补救镇痛率。结果 与C组比较，E组术后24、72h的QoR-40评分中三个维度（身体舒适度、情绪状态及疼痛）得分和总分均升高，术后72h的心理支持得分升高（P<0.05）。与C组比较，E组术后72h的SAS评分和SDS评分均降低，术中丙泊酚和瑞芬太尼用量均减少，苏醒时间和出室时间均缩短，术后1、3、6、12h的VAS疼痛评分均降低（P<0.05或P<0.01）。两组术后不良反应发生率和补救镇痛率相仿（P>0.05）。结论 艾司氯胺酮用于妇科腹腔镜手术的麻醉诱导和维持能够提高患者术后恢复质量，减轻焦虑、抑郁情绪，且不增加术后不良反应的发生。更多还原

【Abstract】 Objective To explore the effects of esketamine on postoperative recovery quality, anxiety and depression in the patients undergoing gynecological laparoscopic surgery.Methods A total of 63 patients undergoing elective gynecological laparoscopic surgery were divided into two groups of E（31cases） and C（32cases）.Esketamine 0.3mg/kg was injected intravenously during anesthesia induction, and esketamine 0.2mg·kg^-1·h^-1 was pumped intravenously during anesthesia maintenance in group E.Equal volume of normal saline was injected intravenously during anesthesia induction and pumped intravenously during anesthesia maintenance respectively in group C.The scores of 40-item quality of recovery scale（QoR-40）,self-rating anxiety scale（SAS） and self-rating depression scale（SDS） during perioperative period were compared between the two groups.The intraoperative consumptions of propofol and remifentanil, the times of awakening and leaving from the operation room were compared between the two groups.The VAS pain scores at 1,3,6,12 and 24 hours after surgery were compared between the two groups.The incidences of postoperative adverse reactions and remedial analgesia were compared between the two groups.Results Compared with group C,the QoR-40 scores（in three dimensions of physical comfort, emotional state and pain） as well as the total score at 24 and 72 hours postoperatively were higher in group E,and the psychological support score was higher at 72 hours postoperatively in group E（P<0.05）.Compared with group C,SAS and SDS scores were lower at 72 hours postoperatively, consumptions of propofol and remifentanil were reduced, the times of awakening and leaving from the operation room were shorter, and VAS pain scores were lower at 1,3,6 and 12 hours postoperatively in group E（P<0.05 or P<0.01）.The incidences of postoperative adverse reactions and remedial analgesia of two groups were similar（P>0.05）.Conclusion In the patients undergoing gynecological laparoscopic surgery, anesthesia induction and maintenance with esketamine can improve the quality of postoperative recovery, alleviate anxiety and depression, and does not increase the incidence of postoperative adverse reactions.更多还原