艾司氯胺酮复合丙泊酚在小儿麻醉中应用的研究进展
Advances in a Combination of Esketamine and Propofol in Pediatric Anesthesia
DOI: 10.12677/ACM.2023.13102303, PDF,   
作者: 王 洋：新疆医科大学研究生学院，新疆 乌鲁木齐；徐桂萍*：新疆维吾尔自治区人民医院麻醉科，新疆麻醉管理临床医学研究中心，新疆 乌鲁木齐
关键词: 艾司氯胺酮；丙泊酚；小儿麻醉；Esketamine； Propofol； Pediatric Anesthesia
摘要: 背景：艾司氯胺酮是氯胺酮的右旋结构，是非竞争性NMDA受体拮抗剂，艾司氯胺酮的镇静镇痛效力高，副作用更少、代谢快、体内清除率高，对患儿呼吸循环影响较轻，苏醒和恢复迅速，在小儿麻醉效果方面有显著的应用价值。近年来，一些研究者将艾司氯胺酮用于小儿麻醉取得了良好的临床麻醉效果。目的：梳理艾司氯胺酮复合丙泊酚在小儿麻醉中应用的研究进展，为临床应用提供参考。内容：概述艾司氯胺酮和丙泊酚的药代动力学，以及两者复合麻醉在患儿创伤性检查、术前及术中的应用。趋向：艾司氯胺酮复合丙泊酚在小儿麻醉中具有广阔的应用前景。
Abstract: Background: Esketamine is the dextrorotatory structure of ketamine and a non-competitive NMDA receptor antagonist. It has high sedative and analgesic efficacy, few side effects, quick metabolism, high in vivo clearance rate, and mild impact on children’s cardiopulmonary circulation, and can produce rapid awakening and postoperative recovery, suggesting its significant application value for improving the pediatric anesthetic effect. In recent years, esketamine has had some applications in pediatric anesthesia and has achieved favorable anesthetic effect clinically. Objective: To review their combining use in pediatric anesthesia and provide further guidance in clinical practice. Con-tent: The article elucidates the pharmacokinetics of esketamine and propofol and their combination applying to invasive examination, pre-operation, intra-operation management. Trend: A combina-tion of esketamine and propofol in pediatric anesthesia will have a promising future.
文章引用：王洋, 徐桂萍. 艾司氯胺酮复合丙泊酚在小儿麻醉中应用的研究进展[J]. 临床医学进展, 2023, 13(10): 16446-16451. https://doi.org/10.12677/ACM.2023.13102303

参考文献

[1] Maraschin, J.C., Frias, A.T., Hernandes, P.M., et al. (2022) Antipanic-Like Effect of Esketamine and Buprenorphine in Rats Exposed to Acute Hypoxia. Behavioural Brain Research, 418, Article ID: 113651. [Google Scholar] [CrossRef] [PubMed]
[2] Eberl, S., Koers, L., van Hooft, J.E., et al. (2017) Sedation with Propofol during ERCP: Is the Combination with Esketamine More Effective and Safer than with Alfentanil? Study Pro-tocol for a Randomized Controlled Trial. Trials, 18, Article No. 472. [Google Scholar] [CrossRef] [PubMed]
[3] Flint, R.B., Brouwer, C., Kranzlin, A., et al. (2017) Pharmacoki-netics of S-ketamine during Prolonged Sedation at the Pediatric Intensive Care Unit. Pediatric Anesthesia, 27, 1098-1107. [Google Scholar] [CrossRef] [PubMed]
[4] 潘秦, 方华, 熊兴龙, 等. 右美托咪定减轻丙泊酚诱导的发育期大鼠学习记忆障碍[J]. 临床麻醉学杂志, 2022, 38(1): 76-80.
[5] Yang, Y., Yi, J., Pan, M., et al. (2021) Edaravone Allevi-ated Propofol-Induced Neurotoxicity in Developing Hippocampus by mBDNF/TrkB/PI3K Pathway. Drug Design, De-velopment and Therapy, 15, 1409-1422. [Google Scholar] [CrossRef] 
[6] Peltoniemi, M.A., Hagelberg, N.M., Olkkola, K.T., et al. (2016) Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy. Clinical Pharmacokinetics, 55, 1059-1077. [Google Scholar] [CrossRef] [PubMed]
[7] Liu, Y., Lin, D., Wu, B., et al. (2016) Ketamine Abuse Potential and Use Disorder. Brain Research Bulletin, 126, 68-73. [Google Scholar] [CrossRef] [PubMed]
[8] Zanos, P., Moaddel, R., Morris, P.J., et al. (2018) Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms. Pharmacological Reviews, 70, 621-660. [Google Scholar] [CrossRef] [PubMed]
[9] Rigby-Jones, A.E. and Sneyd, J.R. (2011) Propofol and Chil-dren—What We Know and What We Do Not Know. Pediatric Anesthesia, 21, 247-254. [Google Scholar] [CrossRef] [PubMed]
[10] Xin, N., Xu, H. and Yue, C. (2021) Comparison between Dexmedetomidine and Esketamine in Pediatric Dentistry Surgery. Translational Pediatrics, 10, 3159-3165. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, J., Hu, W., Zhao, X., et al. (2022) Sedative Effect and Safety of Different Doses of S-Ketamine in Combination with Propofol during Gastro-Duodenoscopy in School-Aged Children: A Prospective, Randomized Study. BMC Anesthesiology, 22, Article No. 346. [Google Scholar] [CrossRef] [PubMed]
[12] 刘玉静, 邢飞, 王绪林, 等. 艾司氯胺酮复合丙泊酚用于患儿MRI检查的镇静效果[J]. 中华麻醉学杂志, 2021, 41(9): 1120-1123.
[13] 姚忠岩, 娄宁, 王玉, 等. 艾司氯胺酮复合丙泊酚用于患儿纤维支气管镜检查术的效果[J]. 中华麻醉学杂志, 2022(11): 1385-1386.
[14] 张浩, 周静, 孙剑, 等. 艾司氯胺酮滴鼻联合丙泊酚在儿童肠镜检查中的应用[J]. 中国新药与临床杂志, 2023, 42(6): 374-377.
[15] Apostolidou, S., Kintscher, M., Schon, G., et al. (2022) The Impact of a Dedicated Sedation Team on the Incidence of Complications in Pediatric Procedural Analgosedation. Children, 9, Article 998. [Google Scholar] [CrossRef] [PubMed]
[16] 刘英, 熊虹飞, 杨亚男, 等. 小剂量氯胺酮对丙泊酚所致儿童不自主运动的影响[J]. 国际麻醉学与复苏杂志, 2020, 41(11): 1057-1061.
[17] 佘锐璇. 不同剂量艾司氯胺酮预处理对丙泊酚引起患儿不自主体动反应的影响[J]. 中国现代药物应用, 2021, 15(15): 182-184.
[18] 张小虹, 牛艳姣, 杨中贞, 等. 丙泊酚、七氟醚联合艾司氯胺酮应用于小儿腹部短小手术中的麻醉效果及不良反应发生情况[J]. 中国药物经济学, 2022, 17(5): 99-102.
[19] Patel, D., Talbot, C., Luo, W., et al. (2021) The Use of Esketamine Seda-tion in the Emergency Department for Manipulation of Paediatric Forearm Fractures: A 5 Year Study. Injury, 52, 1321-1330. [Google Scholar] [CrossRef] [PubMed]
[20] 刘文君, 林多茂, 赵丽云, 等. 不同剂量艾司氯胺酮联合丙泊酚用于先天性心脏病患儿介入手术麻醉的效果[J]. 中国医药, 2023, 18(2): 192-195.
[21] 周兴, 何军民, 雷亨发. 艾司氯胺酮联合丙泊酚对臂丛神经阻滞下小儿上肢手术的镇静效应[J]. 实用药物与临床, 2022, 25(10): 893-896.
[22] 朱明明, 陈媛. 艾司氯胺酮复合丙泊酚对小儿腹股沟疝及鞘膜积液腹膜外结扎术后疼痛的影响[J]. 中国现代医学杂志, 2022, 32(21): 80-85.
[23] Cho, S. and Buss, K.A. (2017) Toddler Parasympathetic Regulation and Fear: Links to Maternal Appraisal and Behavior. Developmental Psychobiology, 59, 197-208. [Google Scholar] [CrossRef] [PubMed]
[24] 盛奎, 胡宪文, 吴云, 等. 低剂量艾司氯胺酮联合丙泊酚在无痛胃肠镜检查中的临床研究[J]. 中国医刊, 2022, 57(3): 341-344.
[25] Chu, Q., Zhu, K., Bai, Y., et al. (2021) A Single Low Dose of Dexmedetomidine Efficiently Attenuates Esketamine- Induced Overactive Behaviors and Neuronal Hyperactivi-ties in Mice. Frontiers in Human Neuroscience, 15, Article No. 735569. [Google Scholar] [CrossRef] [PubMed]

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