艾司氯胺酮在老年腹腔镜下结直肠癌根治术全身麻醉维持中的安全性及VAS影响分析

Analysis of the Safety of Esketamine in the Maintenance of General Anesthesia for Laparoscopic Radical Resection of Colorectal Cancer in Elderly Patients and Its Impact on VAS

摘要: 目的：探讨艾司氯胺酮在老年腹腔镜下结直肠癌根治术全身麻醉维持中的安全性及应用价值。方法：选择腹腔镜下结直肠癌根治术的老年患者118例，按小程序随机排序法分为对照组和艾司氯胺酮组各59例，对照组行常规麻醉方式，艾司氯胺酮组在对照组的基础上在麻醉维持中增加艾司氯胺酮，对比差异性。结果：T₀时组间的VAS评分差异不显著(P > 0.05)，T₁时艾司氯胺酮组的VAS评分低于对照组(P < 0.05)。T₀时组间的MoCA评分差异不显著(P > 0.05)，T₁、T₂及T₃时艾司氯胺酮组的MoCA评分均高于对照组(P < 0.05)。组间不良反应总发生率差异不显著(P > 0.05)。艾司氯胺酮组的意识恢复时间、拔管时间以及麻醉后监护室停留时间均短于对照组(P < 0.05)。结论：艾司氯胺酮在老年腹腔镜下结直肠癌根治术全身麻醉维持中具有较高安全性的同时还能加速患者术后麻醉状态的恢复，对改善其术后疼痛以及认知功能的恢复具有良好的表现，具备临床推荐价值。

Abstract: Objective: To investigate the safety and application value of Esketamine in the maintenance of general anesthesia for elderly patients undergoing laparoscopic radical resection of colorectal cancer. Methods: A total of 118 elderly patients scheduled for laparoscopic radical resection of colorectal cancer were selected and randomly divided into a control group and an Esketamine group, with 59 cases in each group, using a mini-program random sorting method. The control group received conventional anesthesia, while the Esketamine group received additional Esketamine during anesthesia maintenance on the basis of the control group. Differences between the two groups were compared. Results: At T0, there was no significant difference in VAS scores between the two groups (P > 0.05). At T1, the VAS scores of the Esketamine group were lower than those of the control group (P < 0.05). At T0, there was no significant difference in MoCA scores between the two groups (P > 0.05). At T1, T2, and T3, the MoCA scores of the Esketamine group were higher than those of the control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). The consciousness recovery time, extubation time, and post-anesthesia care unit (PACU) stay time in the Esketamine group were shorter than those in the control group (P < 0.05). Conclusion: Esketamine demonstrates high safety during the maintenance of general anesthesia in elderly patients undergoing laparoscopic radical resection of colorectal cancer, while also accelerating the recovery from postoperative anesthesia. It shows beneficial effects in improving postoperative pain and cognitive function recovery, indicating clinical recommendation value.