广西医学

目的探讨雾化吸入艾司氯胺酮对全身麻醉气管插管（全麻插管）患者术后咽喉痛（POST）的影响。方法选择择期在全麻插管仰卧位下行手术治疗的66例患者作为研究对象，采用随机数字表法将患者分为艾司氯胺酮组（S组）和对照组（C组），每组33例。S组接受艾司氯胺酮25 mg加生理盐水4 mL雾化吸入15 min，C组接受生理盐水5 mL雾化吸入15 min。比较两组患者雾化吸入前即刻、麻醉诱导前即刻、麻醉诱导后5 min、麻醉诱导后30 min、麻醉诱导后60 min、拔除气管导管时、出麻醉复苏室（PACU）时的平均动脉压（MAP）及心率，拔除气管导管后2 h、4 h、8 h、12 h、24 h 的POST发生情况，以及不良反应发生情况。结果两组不同时间点MAP及心率差异均无统计学意义（P>0.05）。与雾化吸入前即刻比较，麻醉诱导后5 min、麻醉诱导后30 min、麻醉诱导后60 min、拔除气管导管时、出PACU时C组MAP降低，麻醉诱导前即刻、麻醉诱导后5 min、麻醉诱导后30 min、麻醉诱导后60 min、拔除气管导管时、出PACU时S组MAP及两组心率降低（P<0.05）。S组拔除气管导管后4 h、8 h、12 h、24 h的POST发生率及严重程度低于C组（P<0.05）。S组有1例患者出现恶心呕吐，C组有2例患者出现恶心呕吐，两组不良反应发生率差异无统计学意义（P>0.05）。结论麻醉前雾化吸入艾司氯胺酮可减少全麻插管患者POST的发生率，减轻POST的严重程度，且不良反应发生率低。

Objective To explore the effect of nebulized inhalation of esketamine on postoperative sore throat (POST) in patients with general anesthesia trachea intubation. Methods A total of 66 patients undergoing selective surgical treatment via general anesthesia trachea intubation in supine position were selected as the research subjects. Patients were assigned to esketamine group (group S) or control group (group C) by employing the random number table method, with 33 cases in each group. Group S received nebulized inhalation of 25 mg esketamine plus 4 mL normal saline for 15 minutes, and group C received nebulized inhalation of 5 mL normal saline for 15 minutes. The mean arterial pressure (MAP) and heart rate immediately before nebulized inhalation, immediately anesthesia preinduction, 5 minutes after anesthesia induction, 30 minutes after anesthesia induction, 60 minutes after anesthesia induction, at the time of extubation, on the time of leaving Postanesthesia Care Unit (PACU), and POST occurrence after 2, 4, 8, 12, 24 hours of extubation, as well as the occurrence of adverse reactions were compared between patients of the two groups. Results There was no statistically difference in MAP and heart rate at various time points between the two groups (P>0.05). Compared with immediately before nebulized inhalation, group C exhibited decreased MAP 5 minutes after anesthesia induction, 30 minutes after anesthesia induction, 60 minutes after anesthesia induction, at the time of extubation, on the time of leaving PACU, whereas group S yielded decreased MAP and both groups interpreted decreased heart rate immediately before anesthesia induction, 5 minutes after anesthesia induction, 30 minutes after anesthesia induction, 60 minutes after anesthesia induction, at the time of extubation, and on the time of leaving PACU (P<0.05). Group S depicted lower POST incidence rate and severity after 4, 8, 12, and 24 hours of extubation as compared with group C (P<0.05). There was 1 patient suffering from nausea and vomiting in group S, and 2 patients suffering from nausea and vomiting in group C, and no statistically significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion Nebulized inhalation of esketamine before anesthesia can decreased the incidence rate of POST in patients with general anesthesia trachea intubation, and relieve POST severity, with a low incidence rate of adverse reactions.